Access to care [9,10]. Nonetheless, it hasbeen a long, difficult course of action, plus the results are controversial [11,12]. In spite with the considerable enhance in public well being expenditure from three to six.six of GDP, more than the 1993 to 2007 period [13], around 15.three to 19.3 of your population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of services (POS-S) considerably inferior to that provided by the contributory one [16,17]. About 17 of health expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting daily operations (economic, personnel, and data management) and enrollment processes [19]. Furthermore, numerous research look to indicate a reduce in realized access to solutions [20,21], and point to considerable barriers connected to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as UNC-926 chemical information insurance enrolment [22-28], income [22,25,26,28], education [22-27,29] and, qualities of services, like geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is certainly sensitive towards the general healthcare technique, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, even though per capita 2004 wellness expenditure have been related (USD 549 and USD 598, respectively) but a GNP per capita decrease within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Services Study 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, offered evidence points to failures in the condition sine qua non for the effective implementation of managed competition, according to its supporters [1]: the existence of an efficient regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their potential to handle an excellent number of institutions related to insufficient financial sources, lack of handle mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies of the determinants of use of care in Colombia concentrate on individual variables and initial contact with services, and ignore contextual variables well being policy and qualities of healthcare services. Insurance coverage, measured only by enrolment rate, is normally viewed as an independent variable, even though in managed competitors models, insurers straight influence the provider networks and conditions of access to healthcare [36]. Also, little research has evaluated access from the point of view on the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, because of methodological issues in such as contextual variables [40,41]. The objective of this short article is always to contribute for the improvement of our understanding with the variables influencing access for the continuum of healthcare services within the Colombian managed competitors model, in the point of view of social actors.Techniques There were two Places of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and 1 rural (La Cumbre, Division of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Inside the former, a wide array of insurers are present, while inside the latter only 1 subsidized insurance coverage firm, with all the majority with the contributory insurance enrollees being affiliated in two insurance providers. In both areas the majority of the population reside in poverty [42]. Within the urban region, the coverage of your subsidized regime is slightly less than in the rural a.