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Access to care [9,10]. Nonetheless, it hasbeen a long, difficult approach, as well as the benefits are controversial [11,12]. In spite on the substantial enhance in public overall health expenditure from three to six.6 of GDP, over the 1993 to 2007 period [13], about 15.3 to 19.3 with the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a variety of services (POS-S) tremendously inferior to that offered by the contributory a single [16,17]. Around 17 of well being expenditure is devoted to administrative charges [18], of which greater than 50 is spent on supporting daily operations (economic, personnel, and information management) and enrollment processes [19]. Furthermore, several studies appear to indicate a reduce in realized access to services [20,21], and point to significant barriers related to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, characteristics of solutions, which include geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator that’s sensitive for the all round healthcare technique, was 130/100.000 in Colombia, when compared with 30/ one hundred.000 in Costa Rica, even though per capita 2004 well being expenditure had been similar (USD 549 and USD 598, respectively) but a GNP per capita reduced within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Solutions Investigation 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available evidence points to failures in the situation sine qua non for the prosperous implementation of managed competition, as outlined by its supporters [1]: the existence of an efficient regulatory system. These studies [32-35] reveal deficiencies in regulation authorities in their potential to handle a terrific quantity of institutions connected to insufficient financial sources, lack of handle mechanisms and excessive, and at times contradictory, regulation norms. Most research on the determinants of use of care in Colombia focus on personal variables and initial speak to with solutions, and ignore contextual variables wellness policy and characteristics of healthcare services. Insurance coverage, measured only by enrolment price, is usually viewed as an independent variable, though in managed competition models, insurers straight influence the provider Ro 67-7476 web networks and situations of access to healthcare [36]. Also, small study 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, on account of methodological troubles in such as contextual variables [40,41]. The objective of this short article is usually to contribute towards the improvement of our understanding of your factors influencing access to the continuum of healthcare services in the Colombian managed competitors model, in the point of view of social actors.Approaches There have been two Places of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. In the former, a wide array of insurers are present, even though inside the latter only a single subsidized insurance enterprise, with the majority in the contributory insurance coverage enrollees being affiliated in two insurance firms. In each areas the majority of the population reside in poverty [42]. In the urban region, the coverage on the subsidized regime is slightly less than inside the rural a.