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Access to care [9,10]. Even so, it hasbeen a extended, difficult process, along with the final results are controversial [11,12]. In spite of your important raise in public wellness expenditure from 3 to six.6 of GDP, over the 1993 to 2007 period [13], about 15.three to 19.3 of your population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of NSC23005 (sodium) cost services (POS-S) considerably inferior to that offered by the contributory a single [16,17]. Around 17 of health expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting daily operations (monetary, personnel, and information management) and enrollment processes [19]. In addition, quite a few studies look to indicate a lower in realized access to solutions [20,21], and point to significant barriers related to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, traits of services, for example geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator which is sensitive towards the general healthcare system, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, even though per capita 2004 health expenditure were equivalent (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 Health Services Research 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, out there proof points to failures inside the condition sine qua non for the successful implementation of managed competitors, according to its supporters [1]: the existence of an effective regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their capability to control a terrific number of institutions related to insufficient financial resources, lack of control mechanisms and excessive, and sometimes contradictory, regulation norms. Most studies on the determinants of use of care in Colombia concentrate on personal variables and initial speak to with solutions, and ignore contextual variables health policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment price, is often viewed as an independent variable, while in managed competitors models, insurers directly influence the provider networks and conditions of access to healthcare [36]. In addition, little study has evaluated access from the point of view with the social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, resulting from methodological troubles in like contextual variables [40,41]. The objective of this short article would be to contribute for the improvement of our understanding with the things influencing access to the continuum of healthcare solutions within the Colombian managed competitors model, from the viewpoint of social actors.Solutions There have been two Places of Study: 1 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. Within the former, a wide array of insurers are present, even though in the latter only one subsidized insurance corporation, with the majority of the contributory insurance enrollees becoming affiliated in two insurance businesses. In each areas the majority of the population reside in poverty [42]. In the urban area, the coverage with the subsidized regime is slightly less than within the rural a.