Access to care [9,10]. Even so, it hasbeen a long, complex procedure, along with the final results are controversial [11,12]. In spite with the considerable increase in public wellness expenditure from 3 to six.six of GDP, more than the 1993 to 2007 period , around 15.three to 19.three of your population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime  that covers a variety of solutions (POS-S) tremendously inferior to that provided by the contributory one particular [16,17]. Roughly 17 of well being expenditure is devoted to administrative charges , of which more than 50 is spent on supporting day-to-day operations (monetary, personnel, and data management) and enrollment processes . Furthermore, various research appear to indicate a decrease in realized access to solutions [20,21], and point to substantial barriers connected 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 solutions, which include geographic accessibility and high quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is certainly sensitive for the general healthcare system, was 130/100.000 in Colombia, in CP21 comparison to 30/ one hundred.000 in Costa Rica, whilst per capita 2004 wellness expenditure had been comparable (USD 549 and USD 598, respectively) but a GNP per capita decrease in the former (USD 6130 and USD 9220) .Vargas et al. BMC Health Services Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, out there evidence points to failures inside the situation sine qua non for the thriving implementation of managed competition, according to its supporters : the existence of an efficient regulatory method. These research [32-35] reveal deficiencies in regulation authorities in their capacity to control an awesome variety of institutions associated to insufficient economic sources, lack of control mechanisms and excessive, and at times contradictory, regulation norms. Most research of the determinants of use of care in Colombia focus on individual variables and initial contact with solutions, and ignore contextual variables wellness policy and characteristics of healthcare solutions. Insurance coverage, measured only by enrolment price, is normally viewed as an independent variable, even though in managed competitors models, insurers directly influence the provider networks and situations of access to healthcare . Additionally, little analysis 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, on account of methodological troubles in including contextual variables [40,41]. The objective of this short article is always to contribute towards the improvement of our understanding of the things influencing access towards the continuum of healthcare solutions in the Colombian managed competitors model, in the point of view of social actors.Approaches There were two Locations of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and 1 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, while in the latter only a single subsidized insurance coverage enterprise, using the majority in the contributory insurance enrollees being affiliated in two insurance coverage companies. In each places most of the population live in poverty . Inside the urban area, the coverage from the subsidized regime is slightly much less than within the rural a.