Access to care [9,10]. On the other hand, it hasbeen a lengthy, complex course of action, and also the outcomes are controversial [11,12]. In spite with the important improve in public wellness expenditure from 3 to 6.six of GDP, over the 1993 to 2007 period , about 15.three to 19.3 on the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime  that covers a range of solutions (POS-S) significantly inferior to that supplied by the contributory 1 [16,17]. About 17 of wellness expenditure is devoted to administrative costs , of which greater than 50 is spent on supporting daily operations (economic, personnel, and facts management) and enrollment processes . Furthermore, numerous BBI503 biological activity research seem to indicate a lower in realized access to services [20,21], and point to substantial barriers associated to qualities 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, qualities of services, like geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is definitely sensitive for the all round healthcare technique, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, even though per capita 2004 health expenditure had been comparable (USD 549 and USD 598, respectively) but a GNP per capita reduced inside the former (USD 6130 and USD 9220) .Vargas et al. BMC Overall health Solutions Research 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, available proof points to failures inside the condition sine qua non for the prosperous implementation of managed competitors, according to its supporters : the existence of an efficient regulatory program. These research [32-35] reveal deficiencies in regulation authorities in their capability to manage an awesome number of institutions related to insufficient economic resources, lack of handle mechanisms and excessive, and occasionally contradictory, regulation norms. Most research of the determinants of use of care in Colombia focus on private variables and initial make contact with with services, and ignore contextual variables overall health policy and characteristics of healthcare solutions. Insurance coverage, measured only by enrolment rate, is often viewed as an independent variable, even though in managed competitors models, insurers straight influence the provider networks and conditions of access to healthcare . In addition, little investigation has evaluated access in the point of view from the social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, due to methodological issues in which includes contextual variables [40,41]. The objective of this article should be to contribute for the improvement of our understanding of your things influencing access for the continuum of healthcare solutions inside the Colombian managed competitors model, from the point of view of social actors.Procedures There were two Regions of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and one particular rural (La Cumbre, Department of Valle del Cauca) with 628.672  and 11.122 inhabitants  respectively. Inside the former, a wide array of insurers are present, although within the latter only one particular subsidized insurance coverage business, together with the majority with the contributory insurance enrollees being affiliated in two insurance coverage providers. In each places most of the population live in poverty . Within the urban area, the coverage on the subsidized regime is slightly less than within the rural a.