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Access to care [9,10]. Nonetheless, it hasbeen a extended, complicated procedure, and also the final results are controversial [11,12]. In spite in the significant improve in public wellness expenditure from 3 to 6.6 of GDP, over the 1993 to 2007 period [13], about 15.three to 19.three of your population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a variety of solutions (POS-S) drastically inferior to that provided by the contributory a single [16,17]. Around 17 of overall health expenditure is devoted to administrative charges [18], of which greater than 50 is spent on supporting each day operations (financial, personnel, and data management) and enrollment processes [19]. Moreover, several research look to indicate a decrease in realized access to solutions [20,21], and point to important barriers related 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, such as geographic accessibility and top MedChemExpress BMT-145027 quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that may be sensitive towards the all round healthcare program, was 130/100.000 in Colombia, in comparison with 30/ 100.000 in Costa Rica, when per capita 2004 overall health expenditure have been similar (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 Services Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available evidence points to failures within the condition sine qua non for the productive implementation of managed competitors, in line with its supporters [1]: the existence of an effective regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their capability to manage a terrific quantity of institutions related to insufficient financial resources, lack of control mechanisms and excessive, and occasionally contradictory, regulation norms. Most research of your determinants of use of care in Colombia concentrate on individual variables and initial speak to with solutions, and ignore contextual variables health policy and characteristics of healthcare services. Insurance coverage, measured only by enrolment price, is normally viewed as an independent variable, despite the fact that in managed competition models, insurers directly influence the provider networks and conditions of access to healthcare [36]. Furthermore, little research has evaluated access from the point of view in the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, resulting from methodological troubles in such as contextual variables [40,41]. The objective of this article will be to contribute to the improvement of our understanding on the elements influencing access for the continuum of healthcare services within the Colombian managed competition model, from the perspective of social actors.Approaches There were two Places of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and a single 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 in the latter only 1 subsidized insurance coverage firm, together with the majority from the contributory insurance enrollees getting affiliated in two insurance coverage organizations. In both regions the majority of the population reside in poverty [42]. Within the urban area, the coverage from the subsidized regime is slightly less than within the rural a.