Access to care [9,10]. However, it hasbeen a extended, complex course of action, as well as the final results are controversial [11,12]. In spite from the important improve in public health expenditure from 3 to 6.6 of GDP, over the 1993 to 2007 period [13], around 15.three to 19.three in the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) drastically inferior to that supplied by the contributory one particular [16,17]. Approximately 17 of well being expenditure is devoted to administrative costs [18], of which more than 50 is spent on supporting each day operations (monetary, personnel, and info management) and enrollment processes [19]. In addition, numerous research look to indicate a reduce 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 coverage enrolment [22-28], revenue [22,25,26,28], education [22-27,29] and, characteristics of solutions, including geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality rate, an indicator that is certainly sensitive for the overall healthcare technique, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, although per capita 2004 well being expenditure had been similar (USD 549 and USD 598, respectively) but a GNP per capita lower in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Overall health Services Investigation 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable evidence points to failures inside the condition sine qua non for the thriving implementation of managed competitors, in accordance with its supporters [1]: the existence of an effective regulatory program. These research [32-35] reveal deficiencies in regulation authorities in their capability to manage an incredible quantity of institutions associated to insufficient financial sources, lack of manage mechanisms and excessive, and in some cases contradictory, regulation norms. Most studies in the determinants of use of care in Colombia concentrate on individual variables and initial contact with services, and ignore contextual variables wellness policy and traits of healthcare services. Insurance coverage, measured only by enrolment price, is typically viewed as an independent variable, although in managed competition models, insurers straight influence the provider networks and conditions of access to healthcare [36]. Also, little study has evaluated access in the point of view of your social actors [26,37-39], in spite of the limited capacity of quantitative models in explaining determinants of use of care, as a result of methodological difficulties in like contextual variables [40,41]. The objective of this article is always to contribute for the improvement of our understanding from the factors influencing access for the continuum of healthcare solutions inside the Colombian managed competitors model, in the point of view of social actors.Strategies There had been two Locations of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and 1 rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] Phorbol respectively. Within the former, a wide array of insurers are present, when inside the latter only a single subsidized insurance organization, with the majority of your contributory insurance coverage enrollees becoming affiliated in two insurance firms. In each regions most of the population reside in poverty [42]. Inside the urban region, the coverage from the subsidized regime is slightly significantly less than in the rural a.
