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Access to care [9,10]. However, it hasbeen a extended, difficult course of action, plus the benefits are controversial [11,12]. In spite in the considerable enhance in public well being expenditure from three to six.six of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.3 on the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of solutions (POS-S) considerably inferior to that provided by the contributory one particular [16,17]. About 17 of health expenditure is devoted to administrative costs [18], of which greater than 50 is spent on supporting each day operations (Taprenepag site monetary, personnel, and details management) and enrollment processes [19]. Additionally, several studies look to indicate a decrease in realized access to solutions [20,21], and point to substantial barriers connected to characteristics 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, qualities of services, which include geographic accessibility and high quality of care [26,30]. In 2005, the maternal mortality price, an indicator that’s sensitive to the overall healthcare method, was 130/100.000 in Colombia, when compared with 30/ 100.000 in Costa Rica, whilst per capita 2004 health expenditure had been related (USD 549 and USD 598, respectively) but a GNP per capita decrease within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Services Research 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, obtainable evidence points to failures inside the situation sine qua non for the thriving implementation of managed competition, in line with its supporters [1]: the existence of an efficient regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their potential to handle a great variety of institutions related to insufficient economic resources, lack of handle mechanisms and excessive, and at times contradictory, regulation norms. Most studies of the determinants of use of care in Colombia focus on personal variables and initial contact with solutions, and ignore contextual variables health policy and traits of healthcare services. Insurance coverage, measured only by enrolment price, is generally viewed as an independent variable, even though in managed competition models, insurers straight influence the provider networks and conditions of access to healthcare [36]. Moreover, little analysis 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, as a consequence of methodological difficulties in including contextual variables [40,41]. The objective of this short article would be to contribute towards the improvement of our understanding on the variables influencing access for the continuum of healthcare services in the Colombian managed competitors model, in the point of view of social actors.Techniques There have been two Locations of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and 1 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, though inside the latter only 1 subsidized insurance business, using the majority in the contributory insurance enrollees getting affiliated in two insurance firms. In both regions most of the population live in poverty [42]. In the urban area, the coverage on the subsidized regime is slightly less than inside the rural a.