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Access to care [9,10]. On the other hand, it hasbeen a lengthy, complex process, and the final results are controversial [11,12]. In spite with the significant boost in public RIPA-56 custom synthesis overall health expenditure from three to 6.6 of GDP, more than the 1993 to 2007 period [13], around 15.three to 19.3 with the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of solutions (POS-S) considerably inferior to that offered by the contributory one particular [16,17]. Approximately 17 of well being expenditure is devoted to administrative fees [18], of which greater than 50 is spent on supporting each day operations (financial, personnel, and data management) and enrollment processes [19]. Moreover, quite a few studies appear to indicate a lower in realized access to services [20,21], and point to substantial barriers related to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, traits of solutions, including geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality price, an indicator that may be sensitive towards the general healthcare technique, was 130/100.000 in Colombia, in comparison with 30/ one hundred.000 in Costa Rica, although per capita 2004 overall health expenditure had been similar (USD 549 and USD 598, respectively) but a GNP per capita lower inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Solutions Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, available proof points to failures inside the condition sine qua non for the productive implementation of managed competitors, according to its supporters [1]: the existence of an effective regulatory technique. These studies [32-35] reveal deficiencies in regulation authorities in their potential to manage an incredible variety of institutions connected to insufficient monetary sources, lack of handle mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies of your determinants of use of care in Colombia concentrate on personal variables and initial contact with services, and ignore contextual variables wellness policy and qualities of healthcare services. Insurance coverage, measured only by enrolment rate, is generally viewed as an independent variable, though in managed competition models, insurers directly influence the provider networks and situations of access to healthcare [36]. In addition, small analysis has evaluated access from the point of view of the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, as a consequence of methodological troubles in which includes contextual variables [40,41]. The objective of this short article will be to contribute to the improvement of our understanding with the variables influencing access for the continuum of healthcare solutions inside the Colombian managed competitors model, from the point of view of social actors.Strategies There were two Areas of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Department 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 in the latter only one particular subsidized insurance coverage corporation, using the majority of the contributory insurance enrollees getting affiliated in two insurance coverage firms. In each places the majority of the population live in poverty [42]. In the urban location, the coverage of your subsidized regime is slightly less than in the rural a.