Access to care [9,10]. Having said that, it hasbeen a long, complex course of action, plus the results are controversial [11,12]. In spite from the HDAC-IN-3 substantial increase in public wellness expenditure from three to six.6 of GDP, over the 1993 to 2007 period [13], around 15.three to 19.3 from the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) significantly inferior to that provided by the contributory one particular [16,17]. Roughly 17 of wellness expenditure is devoted to administrative fees [18], of which more than 50 is spent on supporting each day operations (financial, personnel, and information and facts management) and enrollment processes [19]. Furthermore, many studies seem to indicate a decrease in realized access to services [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], earnings [22,25,26,28], education [22-27,29] and, traits of solutions, such as geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is certainly sensitive for the overall healthcare system, was 130/100.000 in Colombia, in comparison with 30/ one hundred.000 in Costa Rica, whilst per capita 2004 wellness expenditure have 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 Wellness Solutions Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, accessible evidence points to failures inside the condition sine qua non for the successful implementation of managed competition, in accordance with its supporters [1]: the existence of an efficient regulatory method. These research [32-35] reveal deficiencies in regulation authorities in their ability to control an incredible quantity of institutions associated to insufficient economic resources, lack of manage mechanisms and excessive, and from time to time contradictory, regulation norms. Most research in the determinants of use of care in Colombia focus on personal variables and initial contact with solutions, and ignore contextual variables overall health policy and characteristics of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is often viewed as an independent variable, even though in managed competitors models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Furthermore, tiny study has evaluated access in the point of view on the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, as a consequence of methodological difficulties in such as contextual variables [40,41]. The objective of this short article should be to contribute for the improvement of our understanding of the variables influencing access towards the continuum of healthcare solutions in the Colombian managed competitors model, in the perspective of social actors.Techniques There were two Places 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, although within the latter only a single subsidized insurance coverage organization, using the majority with the contributory insurance coverage enrollees becoming affiliated in two insurance providers. In each areas most of the population reside in poverty [42]. Within the urban location, the coverage with the subsidized regime is slightly much less than inside the rural a.