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Access to care [9,10]. Having said that, it hasbeen a extended, complex procedure, along with the outcomes are controversial [11,12]. In spite from the considerable enhance in public well being expenditure from 3 to 6.6 of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three of the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of services (POS-S) drastically inferior to that supplied by the contributory 1 [16,17]. Roughly 17 of wellness expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting day-to-day operations (economic, personnel, and information management) and enrollment processes [19]. Additionally, a number of research appear to indicate a lower in realized access to solutions [20,21], and point to significant barriers Gly-Pro-Arg-Pro acetate chemical information 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, like geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is definitely sensitive for the all round healthcare program, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, although per capita 2004 well being expenditure were equivalent (USD 549 and USD 598, respectively) but a GNP per capita reduce within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Solutions Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, accessible proof points to failures inside the situation sine qua non for the successful implementation of managed competitors, in line with its supporters [1]: the existence of an efficient regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their potential to manage an excellent variety of institutions related to insufficient monetary sources, lack of manage mechanisms and excessive, and from time to time contradictory, regulation norms. Most studies on the determinants of use of care in Colombia concentrate on private variables and initial make contact with with solutions, and ignore contextual variables overall health policy and qualities of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is usually viewed as an independent variable, even though in managed competitors models, insurers straight influence the provider networks and situations of access to healthcare [36]. Additionally, little study has evaluated access in 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, resulting from methodological difficulties in which includes contextual variables [40,41]. The objective of this article would be to contribute for the improvement of our understanding of the factors influencing access for the continuum of healthcare services inside the Colombian managed competitors model, in the viewpoint of social actors.Approaches There had been two Regions of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and one 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, when within the latter only one subsidized insurance coverage enterprise, using the majority of your contributory insurance coverage enrollees being affiliated in two insurance corporations. In both regions the majority of the population live in poverty [42]. Within the urban region, the coverage of the subsidized regime is slightly significantly less than in the rural a.