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Access to care [9,10]. On the other hand, it hasbeen a long, complex approach, along with the benefits are controversial [11,12]. In spite of your significant enhance in public wellness expenditure from three to 6.six of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three of your population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a variety of services (POS-S) significantly inferior to that supplied by the contributory 1 [16,17]. Roughly 17 of health expenditure is devoted to administrative costs [18], of which more than 50 is spent on supporting day-to-day operations (financial, personnel, and information management) and enrollment processes [19]. Moreover, numerous studies seem to indicate a lower in realized access to services [20,21], and point to important barriers associated to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance purchase GDC-0077 enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, characteristics of services, for example geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality rate, an indicator which is sensitive to the all round healthcare method, was 130/100.000 in Colombia, when compared with 30/ one hundred.000 in Costa Rica, although per capita 2004 health expenditure had 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 Health Services Study 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, available evidence points to failures inside the situation sine qua non for the prosperous implementation of managed competitors, based on its supporters [1]: the existence of an efficient regulatory technique. These research [32-35] reveal deficiencies in regulation authorities in their potential to manage an excellent variety of institutions connected to insufficient monetary sources, lack of handle mechanisms and excessive, and sometimes contradictory, regulation norms. Most research on the determinants of use of care in Colombia focus on private variables and initial make contact with with solutions, and ignore contextual variables health policy and traits of healthcare services. Insurance coverage, measured only by enrolment rate, is frequently viewed as an independent variable, despite the fact that in managed competitors models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. In addition, small research has evaluated access in the point of view on the social actors [26,37-39], regardless of the limited capacity of quantitative models in explaining determinants of use of care, on account of methodological issues in like contextual variables [40,41]. The objective of this short article is usually to contribute for the improvement of our understanding from the elements influencing access for the continuum of healthcare solutions in the Colombian managed competitors model, from the point of view of social actors.Techniques There had been two Areas of Study: a single 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. Inside the former, a wide array of insurers are present, even though in the latter only one particular subsidized insurance coverage company, with the majority from the contributory insurance coverage enrollees getting affiliated in two insurance companies. In both places the majority of the population live in poverty [42]. In the urban location, the coverage of your subsidized regime is slightly less than within the rural a.