Access to care [9,10]. However, it hasbeen a long, complex procedure, along with the results are controversial [11,12]. In spite on the important enhance in public overall health expenditure from three to 6.six of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three on the population remains uninsured [14,15]; and 38.7 are insured beneath the subsidized regime [15] that covers a range of solutions (POS-S) considerably inferior to that offered by the contributory a single [16,17]. Roughly 17 of well being expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting everyday operations (financial, personnel, and information management) and enrollment processes [19]. Furthermore, various studies seem to indicate a reduce in realized access to services [20,21], and point to substantial barriers related to qualities 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, traits of services, including geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality rate, an indicator which is sensitive towards the all round healthcare system, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, though per capita 2004 wellness expenditure have been related (USD 549 and USD 598, respectively) but a GNP per capita reduce in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Well being Services Research 2010, ten:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable evidence RG1662 points to failures inside the situation sine qua non for the successful implementation of managed competitors, as outlined by its supporters [1]: the existence of an efficient regulatory program. These research [32-35] reveal deficiencies in regulation authorities in their capability to manage an awesome variety of institutions connected to insufficient monetary resources, lack of handle mechanisms and excessive, and in some cases contradictory, regulation norms. Most research of your determinants of use of care in Colombia concentrate on personal variables and initial speak to with solutions, and ignore contextual variables overall health policy and qualities of healthcare solutions. Insurance coverage coverage, measured only by enrolment rate, is usually viewed as an independent variable, though in managed competition models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Moreover, tiny investigation has evaluated access in the point of view of the social actors [26,37-39], regardless of the limited capacity of quantitative models in explaining determinants of use of care, as a consequence of methodological issues in which includes contextual variables [40,41]. The objective of this article is usually to contribute for the improvement of our understanding of your things influencing access towards the continuum of healthcare solutions in the Colombian managed competition model, in the point of view of social actors.Techniques There have been two Areas of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and one 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, even though inside the latter only a single subsidized insurance corporation, with the majority with the contributory insurance enrollees being affiliated in two insurance businesses. In each regions most of the population live in poverty [42]. In the urban location, the coverage on the subsidized regime is slightly less than in the rural a.
