Access to care [9,10]. Nonetheless, it hasbeen a lengthy, difficult method, along with the outcomes are controversial [11,12]. In spite of your substantial increase in public health expenditure from three to 6.six of GDP, more than the 1993 to 2007 period , about 15.three to 19.three on the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime  that covers a range of services (POS-S) considerably inferior to that provided by the contributory 1 [16,17]. About 17 of health expenditure is devoted to administrative charges , of which more than 50 is spent on supporting day-to-day operations (economic, personnel, and data management) and enrollment processes . In addition, numerous research look to indicate a decrease in realized access to solutions [20,21], and point to significant barriers related to characteristics of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, qualities of services, such as geographic accessibility and top quality of care [26,30]. In 2005, the maternal mortality price, an indicator which is sensitive for the overall healthcare technique, was 130/100.000 in Colombia, compared to 30/ 100.000 in Costa Rica, even though per capita 2004 well being expenditure have been related (USD 549 and USD 598, respectively) but a GNP per capita decrease inside the former (USD 6130 and USD 9220) .Vargas et al. BMC Overall health Solutions Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, readily available evidence points to failures inside the situation sine qua non for the thriving 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 ability to handle an excellent variety of institutions connected to insufficient financial resources, lack of handle mechanisms and excessive, and in some cases contradictory, regulation norms. Most research in the determinants of use of care in Colombia focus on individual variables and initial make contact with with solutions, and ignore contextual variables wellness policy and qualities of healthcare solutions. Insurance coverage coverage, measured only by enrolment rate, is normally viewed as an independent variable, while in managed competitors models, insurers directly influence the provider networks and conditions of access to healthcare . Furthermore, tiny study has evaluated access in the point of view in the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, due to methodological issues in such as contextual variables [40,41]. The objective of this short article should be to contribute for the order DEL-22379 improvement of our understanding from the variables influencing access for the continuum of healthcare services inside the Colombian managed competitors model, from the perspective of social actors.Techniques There were two Areas of Study: 1 urban (Ciudad Bol ar, Bogot? D.C.) and one particular rural (La Cumbre, Division of Valle del Cauca) with 628.672  and 11.122 inhabitants  respectively. Inside the former, a wide array of insurers are present, even though inside the latter only one particular subsidized insurance business, with the majority of the contributory insurance coverage enrollees getting affiliated in two insurance coverage organizations. In both areas the majority of the population live in poverty . In the urban region, the coverage on the subsidized regime is slightly less than in the rural a.