Access to care [9,10]. On the other hand, it hasbeen a lengthy, complex process, as well as the final results are controversial [11,12]. In spite with the considerable increase in public well being expenditure from 3 to 6.6 of GDP, more than the 1993 to 2007 period , about 15.3 to 19.three of your population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime  that covers a range of services (POS-S) significantly inferior to that provided by the contributory a single [16,17]. About 17 of overall health expenditure is devoted to administrative expenses , of which more than 50 is spent on supporting daily operations (monetary, personnel, and information management) and enrollment processes . Furthermore, numerous studies seem to indicate a reduce in realized access to solutions [20,21], and point to important barriers associated 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 services, for instance geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality price, an indicator that is sensitive to the overall healthcare program, was 130/100.000 in Colombia, compared to 30/ one hundred.000 in Costa Rica, although per capita 2004 wellness expenditure have been equivalent (USD 549 and USD 598, respectively) but a GNP per capita decrease in the former (USD 6130 and USD 9220) .Vargas et al. BMC Well being Solutions Analysis 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, available proof points to failures inside the condition sine qua non for the productive implementation of managed competitors, according to its supporters : the existence of an purchase UNC-926 efficient regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their capability to control a fantastic number of institutions related to insufficient monetary sources, lack of control mechanisms and excessive, and occasionally contradictory, regulation norms. Most research from the determinants of use of care in Colombia concentrate on personal variables and initial make contact with with services, and ignore contextual variables overall health policy and qualities of healthcare services. Insurance coverage, measured only by enrolment price, is usually viewed as an independent variable, even though in managed competitors models, insurers straight influence the provider networks and circumstances of access to healthcare . Furthermore, little research has evaluated access in the point of view of your social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, due to methodological issues in including contextual variables [40,41]. The objective of this article is usually to contribute towards the improvement of our understanding in the elements influencing access towards the continuum of healthcare solutions inside the Colombian managed competitors model, in the point of view of social actors.Solutions There were two Locations 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. In the former, a wide array of insurers are present, even though in the latter only one particular subsidized insurance corporation, together with the majority from the contributory insurance enrollees being affiliated in two insurance coverage firms. In each places the majority of the population live in poverty . In the urban region, the coverage of the subsidized regime is slightly much less than in the rural a.