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Access to care [9,10]. Having said that, it hasbeen a lengthy, difficult method, and also the benefits are controversial [11,12]. In spite of your substantial raise in public overall health expenditure from 3 to 6.six of GDP, over 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) greatly inferior to that offered by the contributory one particular [16,17]. Roughly 17 of overall health expenditure is devoted to administrative costs [18], of which greater than 50 is spent on supporting every day operations (financial, personnel, and facts management) and enrollment processes [19]. Furthermore, many studies appear to indicate a reduce in realized access to solutions [20,21], and point to significant barriers associated to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance PG-1016548 chemical information coverage enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, qualities of services, for example geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is certainly sensitive for the general healthcare system, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, whilst per capita 2004 well being expenditure have been similar (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 Overall health Solutions Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, accessible proof points to failures in the situation sine qua non for the profitable implementation of managed competition, based on its supporters [1]: the existence of an efficient regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their capacity to manage a great quantity of institutions connected to insufficient economic resources, lack of manage mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies with the determinants of use of care in Colombia concentrate on private variables and initial contact with solutions, and ignore contextual variables health policy and traits of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is generally viewed as an independent variable, though in managed competitors models, insurers straight influence the provider networks and situations of access to healthcare [36]. Also, little analysis has evaluated access in the point of view with the social actors [26,37-39], in spite of the limited capacity of quantitative models in explaining determinants of use of care, because of methodological troubles in like contextual variables [40,41]. The objective of this article is usually to contribute for the improvement of our understanding of the things influencing access towards the continuum of healthcare services within the Colombian managed competition model, from the perspective of social actors.Techniques There had been two Regions 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, although in the latter only one particular subsidized insurance enterprise, together with the majority on the contributory insurance enrollees getting affiliated in two insurance coverage organizations. In each regions most of the population live in poverty [42]. In the urban area, the coverage with the subsidized regime is slightly significantly less than in the rural a.