Access to care [9,10]. On the other hand, it hasbeen a long, complicated method, and also the outcomes are controversial [11,12]. In spite from the considerable improve in public overall health expenditure from three to 6.6 of GDP, more than the 1993 to 2007 period , around 15.3 to 19.three with the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime  that covers a range of services (POS-S) greatly inferior to that offered by the contributory one particular [16,17]. Approximately 17 of wellness expenditure is devoted to administrative costs , of which greater than 50 is spent on supporting daily operations (monetary, personnel, and facts management) and enrollment processes . Moreover, numerous studies appear to indicate a reduce in realized access to services [20,21], and point to considerable barriers connected to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], income [22,25,26,28], (??)-Monastro cost education [22-27,29] and, traits of solutions, which include geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is certainly sensitive to the all round healthcare system, was 130/100.000 in Colombia, in comparison with 30/ one hundred.000 in Costa Rica, whilst per capita 2004 well being expenditure were related (USD 549 and USD 598, respectively) but a GNP per capita reduced inside the former (USD 6130 and USD 9220) .Vargas et al. BMC Wellness Solutions Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, available proof points to failures in the situation sine qua non for the prosperous implementation of managed competitors, in accordance with its supporters : the existence of an effective regulatory program. These studies [32-35] reveal deficiencies in regulation authorities in their potential to handle a terrific variety of institutions connected to insufficient monetary sources, lack of control mechanisms and excessive, and from time to time contradictory, regulation norms. Most research in the determinants of use of care in Colombia concentrate on private variables and initial contact with services, and ignore contextual variables wellness policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment rate, is normally viewed as an independent variable, despite the fact that in managed competitors models, insurers straight influence the provider networks and situations of access to healthcare . Also, little analysis has evaluated access from the point of view from the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, on account of methodological troubles in including contextual variables [40,41]. The objective of this article is always to contribute towards the improvement of our understanding on the factors influencing access towards the continuum of healthcare solutions in the Colombian managed competitors model, from the perspective of social actors.Procedures There have been two Areas of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Division of Valle del Cauca) with 628.672  and 11.122 inhabitants  respectively. Within the former, a wide array of insurers are present, when within the latter only a single subsidized insurance coverage enterprise, together with the majority of the contributory insurance coverage enrollees becoming affiliated in two insurance coverage firms. In both regions the majority of the population live in poverty . Inside the urban location, the coverage from the subsidized regime is slightly much less than inside the rural a.