Access to care [9,10]. However, it hasbeen a lengthy, complex process, as well as the final results are controversial [11,12]. In spite from the substantial increase in public overall health expenditure from 3 to six.6 of GDP, over the 1993 to 2007 period , about 15.3 to 19.three of the population remains CC122 site uninsured [14,15]; and 38.7 are insured below the subsidized regime  that covers a range of services (POS-S) greatly inferior to that supplied by the contributory 1 [16,17]. About 17 of well being expenditure is devoted to administrative charges , of which greater than 50 is spent on supporting each day operations (financial, personnel, and information management) and enrollment processes . Moreover, various research seem to indicate a decrease in realized access to services [20,21], and point to considerable barriers connected to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], income [22,25,26,28], education [22-27,29] and, qualities of solutions, including geographic accessibility and good quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is certainly sensitive towards the general healthcare system, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, whilst per capita 2004 health expenditure had been equivalent (USD 549 and USD 598, respectively) but a GNP per capita reduced within the former (USD 6130 and USD 9220) .Vargas et al. BMC Overall health Services Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable proof points to failures within the situation sine qua non for the prosperous implementation of managed competitors, based on its supporters : the existence of an efficient regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their capacity to control a great quantity of institutions related to insufficient monetary resources, lack of manage mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies on the determinants of use of care in Colombia concentrate on private variables and initial speak to with services, and ignore contextual variables wellness policy and characteristics of healthcare solutions. Insurance coverage coverage, measured only by enrolment rate, is usually viewed as an independent variable, despite the fact that in managed competition models, insurers straight influence the provider networks and conditions of access to healthcare . Furthermore, small investigation has evaluated access from the point of view on the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, because of methodological difficulties in which includes contextual variables [40,41]. The objective of this short article should be to contribute for the improvement of our understanding of your aspects influencing access towards the continuum of healthcare solutions in the Colombian managed competitors model, from the point of view of social actors.Solutions There have been two Regions 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. In the former, a wide array of insurers are present, when inside the latter only one subsidized insurance coverage corporation, with the majority of the contributory insurance coverage enrollees getting affiliated in two insurance organizations. In each areas most of the population reside in poverty . In the urban location, the coverage in the subsidized regime is slightly significantly less than in the rural a.