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Access to care [9,10]. On the other hand, it hasbeen a extended, complicated approach, and the final results are controversial [11,12]. In spite of the substantial raise 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.three of the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a range of services (POS-S) drastically inferior to that offered by the contributory one particular [16,17]. Approximately 17 of wellness expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting daily operations (economic, personnel, and information and facts management) and enrollment processes [19]. Furthermore, numerous studies look to indicate a lower in realized access to solutions [20,21], and point to considerable barriers connected to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, characteristics of solutions, for example geographic accessibility and high-quality of care [26,30]. In 2005, the γ-Glutamylphenylalanine web maternal mortality price, an indicator that is definitely sensitive towards the overall healthcare program, was 130/100.000 in Colombia, compared to 30/ 100.000 in Costa Rica, when per capita 2004 wellness expenditure have been related (USD 549 and USD 598, respectively) but a GNP per capita reduced inside the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Solutions Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, available evidence points to failures within the situation sine qua non for the productive implementation of managed competitors, in accordance with its supporters [1]: the existence of an efficient regulatory technique. These research [32-35] reveal deficiencies in regulation authorities in their capacity to manage an awesome variety of institutions related to insufficient financial resources, lack of control mechanisms and excessive, and occasionally contradictory, regulation norms. Most studies with the determinants of use of care in Colombia focus on personal variables and initial get in touch with with services, and ignore contextual variables overall health policy and traits of healthcare services. Insurance coverage, measured only by enrolment rate, is often viewed as an independent variable, though in managed competitors models, insurers directly influence the provider networks and conditions of access to healthcare [36]. Also, little investigation has evaluated access from the point of view with the social actors [26,37-39], regardless of the restricted capacity of quantitative models in explaining determinants of use of care, as a result of methodological troubles in which includes contextual variables [40,41]. The objective of this short article should be to contribute to the improvement of our understanding of your aspects influencing access for the continuum of healthcare solutions in the Colombian managed competition model, in the perspective of social actors.Methods There have been two Areas of Study: 1 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, even though in the latter only a single subsidized insurance coverage company, with all the majority of your contributory insurance coverage enrollees getting affiliated in two insurance companies. In both regions most of the population live in poverty [42]. Within the urban area, the coverage on the subsidized regime is slightly much less than within the rural a.