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Access to care [9,10]. Having said that, it hasbeen a extended, complex procedure, and the results are controversial [11,12]. In spite in the substantial enhance in public health expenditure from three to six.six of GDP, more than the 1993 to 2007 period [13], around 15.3 to 19.three with the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a range of services (POS-S) tremendously inferior to that offered by the contributory one [16,17]. Around 17 of overall health expenditure is devoted to administrative charges [18], of which greater than 50 is spent on supporting every day operations (monetary, personnel, and details management) and enrollment processes [19]. Moreover, many studies seem to indicate a decrease in realized access to solutions [20,21], and point to significant barriers related to traits of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, traits of solutions, such as geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator that’s sensitive towards the all round healthcare method, was 130/100.000 in Colombia, in comparison to 30/ one hundred.000 in Costa Rica, though per capita 2004 well being expenditure had been comparable (USD 549 and USD 598, respectively) but a GNP per capita lower within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Overall health Solutions Study 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, accessible evidence points to failures inside the condition sine qua non for the profitable implementation of managed competition, in line with its supporters [1]: the existence of an efficient regulatory system. These research [32-35] reveal deficiencies in regulation authorities in their ability to handle an incredible number of institutions associated to insufficient monetary resources, lack of handle mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies from the determinants of use of care in Colombia focus on private variables and initial make contact with with solutions, and ignore contextual variables health policy and characteristics of healthcare services. Insurance coverage coverage, measured only by enrolment price, is generally viewed as an independent variable, despite the fact that in managed competitors models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Furthermore, little study has evaluated access from the point of view with the purchase BD1063 (dhydrochloride) social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, resulting from methodological difficulties in such as contextual variables [40,41]. The objective of this article should be to contribute towards the improvement of our understanding with the factors influencing access towards the continuum of healthcare solutions inside the Colombian managed competitors model, in the point of view of social actors.Strategies There had been two Regions of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and 1 rural (La Cumbre, Division of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. In the former, a wide array of insurers are present, when in the latter only a single subsidized insurance firm, together with the majority with the contributory insurance enrollees getting affiliated in two insurance providers. In both areas most of the population live in poverty [42]. Within the urban location, the coverage of the subsidized regime is slightly less than in the rural a.