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Access to care [9,10]. Having said that, it hasbeen a long, complicated process, and the benefits are controversial [11,12]. In spite with the important boost in public wellness expenditure from three to 6.6 of GDP, over the 1993 to 2007 period [13], about 15.3 to 19.three on 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 one [16,17]. Roughly 17 of wellness expenditure is devoted to administrative charges [18], of which more than 50 is spent on supporting each day operations (economic, personnel, and info management) and enrollment processes [19]. In addition, many studies look to indicate a decrease in realized access to solutions [20,21], and point to important barriers associated to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], income [22,25,26,28], education [22-27,29] and, traits of services, for instance geographic accessibility and high quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is certainly sensitive towards the general healthcare technique, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, although per capita 2004 wellness expenditure were related (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 Health Solutions Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, accessible evidence points to failures within the condition sine qua non for the profitable implementation of managed competitors, according to its supporters [1]: the existence of an effective regulatory technique. These studies [32-35] reveal deficiencies in regulation authorities in their TD-198946 manufacturer ability to manage a fantastic quantity of institutions related to insufficient economic resources, lack of handle mechanisms and excessive, and often contradictory, regulation norms. Most studies from the determinants of use of care in Colombia focus on personal variables and initial get in touch with with solutions, and ignore contextual variables wellness policy and characteristics of healthcare services. Insurance coverage coverage, measured only by enrolment price, is typically viewed as an independent variable, despite the fact that in managed competitors models, insurers directly influence the provider networks and situations of access to healthcare [36]. Furthermore, tiny research has evaluated access in the point of view from the social actors [26,37-39], regardless of the limited capacity of quantitative models in explaining determinants of use of care, resulting from methodological issues in like contextual variables [40,41]. The objective of this article will be to contribute for the improvement of our understanding with the things influencing access to the continuum of healthcare solutions inside the Colombian managed competitors model, in the viewpoint of social actors.Techniques There have been two Regions of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and a single 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, though within the latter only 1 subsidized insurance organization, with all the majority from the contributory insurance enrollees becoming affiliated in two insurance coverage organizations. In both places most of the population reside in poverty [42]. Within the urban location, the coverage in the subsidized regime is slightly significantly less than inside the rural a.