Access to care [9,10]. Having said that, it hasbeen a lengthy, difficult process, and the outcomes are controversial [11,12]. In spite of the considerable improve in public well being expenditure from three to 6.six of GDP, over the 1993 to 2007 period , around 15.3 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) drastically inferior to that provided by the contributory 1 [16,17]. Around 17 of overall health expenditure is devoted to administrative fees , of which more than 50 is spent on supporting every day operations (financial, personnel, and info management) and enrollment processes . Moreover, quite a few studies seem to indicate a reduce in realized access to services [20,21], and point to significant barriers associated to characteristics 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 excellent of care [26,30]. In 2005, the maternal mortality rate, an indicator that is sensitive towards the overall healthcare system, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, whilst per capita 2004 well being expenditure were similar (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 Investigation 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, accessible proof points to failures in the condition sine qua non for the successful implementation of managed competition, in accordance with its supporters : the existence of an efficient regulatory program. These research [32-35] reveal deficiencies in regulation authorities in their potential to handle a great quantity of institutions associated to insufficient economic sources, lack of handle mechanisms and excessive, and at times contradictory, regulation norms. Most studies on the determinants of use of care in Colombia focus on individual variables and initial make contact with with services, and ignore contextual variables health policy and characteristics of healthcare solutions. Insurance coverage coverage, measured only by enrolment price, is typically viewed as an independent variable, despite the fact that in managed competition models, insurers directly influence the provider networks and conditions of access to healthcare . Also, small research has evaluated access from 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, as a consequence of methodological issues in including contextual variables [40,41]. The objective of this short article is usually to contribute towards the improvement of our understanding with the variables influencing access towards the GSK1016790A site continuum of healthcare solutions inside the Colombian managed competitors model, in the viewpoint of social actors.Methods There had been two Areas of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and a single rural (La Cumbre, Department of Valle del Cauca) with 628.672  and 11.122 inhabitants  respectively. Within the former, a wide array of insurers are present, whilst within the latter only one particular subsidized insurance coverage firm, using the majority with the contributory insurance coverage enrollees being affiliated in two insurance coverage companies. In both areas most of the population live in poverty . Inside the urban area, the coverage of the subsidized regime is slightly less than within the rural a.