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Access to care [9,10]. However, it hasbeen a long, complicated method, and the final results are controversial [11,12]. In spite from the considerable enhance in public wellness expenditure from three to 6.6 of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.3 of the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of services (POS-S) tremendously inferior to that offered by the contributory one particular [16,17]. About 17 of well being expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting every day operations (monetary, personnel, and information management) and enrollment processes [19]. Furthermore, numerous research seem to indicate a decrease in realized access to services [20,21], and point to substantial barriers associated to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], income [22,25,26,28], education [22-27,29] and, qualities of solutions, including geographic accessibility and high quality of care [26,30]. In 2005, the maternal mortality price, an indicator which is RAD1901 chemical information sensitive to the general healthcare program, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, while per capita 2004 health expenditure had been related (USD 549 and USD 598, respectively) but a GNP per capita lower within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Overall health Solutions Research 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, obtainable evidence points to failures in the situation sine qua non for the profitable implementation of managed competitors, in line with its supporters [1]: the existence of an efficient regulatory technique. These research [32-35] reveal deficiencies in regulation authorities in their ability to manage a fantastic variety of institutions connected to insufficient financial sources, lack of control mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies on the determinants of use of care in Colombia focus on personal variables and initial get in touch with with services, and ignore contextual variables wellness policy and traits of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is usually viewed as an independent variable, even though in managed competition models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. Additionally, small analysis has evaluated access in the point of view in the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, due to methodological troubles in which includes contextual variables [40,41]. The objective of this short article should be to contribute for the improvement of our understanding on the components influencing access to the continuum of healthcare solutions inside the Colombian managed competition model, from the point of view of social actors.Methods There had been two Places of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and a single rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Within the former, a wide array of insurers are present, though inside the latter only a single subsidized insurance coverage enterprise, together with the majority from the contributory insurance coverage enrollees being affiliated in two insurance businesses. In both locations the majority of the population live in poverty [42]. In the urban region, the coverage on the subsidized regime is slightly much less than in the rural a.