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Access to care [9,10]. However, it hasbeen a long, complicated approach, plus the outcomes are controversial [11,12]. In spite of the substantial enhance in public wellness expenditure from 3 to 6.six of GDP, over the 1993 to 2007 period [13], around 15.3 to 19.3 of your population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a range of services (POS-S) greatly inferior to that supplied by the contributory a single [16,17]. About 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 information management) and enrollment processes [19]. Additionally, numerous research appear to indicate a decrease in realized access to solutions [20,21], and point to important barriers associated to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], income [22,25,26,28], education [22-27,29] and, characteristics of solutions, such as geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is sensitive to the general healthcare system, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, even though per capita 2004 overall health expenditure had been related (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 Well being Services Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable evidence points to failures within the situation sine qua non for the effective implementation of managed competition, based on its supporters [1]: the existence of an efficient regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their capability to manage a great number of institutions associated to insufficient economic sources, lack of control mechanisms and TAPI-2 chemical information excessive, and sometimes contradictory, regulation norms. Most studies of the determinants of use of care in Colombia concentrate on private variables and initial contact with services, and ignore contextual variables well being policy and characteristics of healthcare solutions. Insurance coverage, measured only by enrolment rate, is often viewed as an independent variable, while in managed competition models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Furthermore, little research has evaluated access from the point of view from the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, on account of methodological difficulties in including contextual variables [40,41]. The objective of this short article should be to contribute towards the improvement of our understanding on the things influencing access towards the continuum of healthcare solutions within the Colombian managed competitors model, from the viewpoint of social actors.Techniques There were two Areas of Study: 1 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. Within the former, a wide array of insurers are present, even though inside the latter only a single subsidized insurance coverage business, using the majority with the contributory insurance coverage enrollees getting affiliated in two insurance providers. In each regions most of the population reside in poverty [42]. Inside the urban area, the coverage of your subsidized regime is slightly much less than within the rural a.