Access to care [9,10]. Even so, it hasbeen a extended, difficult approach, along with the results are controversial [11,12]. In spite on the substantial improve in public overall health GDC-0853 cost expenditure from three to 6.six of GDP, more than the 1993 to 2007 period [13], about 15.3 to 19.three with the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a variety of services (POS-S) significantly inferior to that supplied by the contributory one [16,17]. Roughly 17 of health expenditure is devoted to administrative expenses [18], of which greater than 50 is spent on supporting daily operations (economic, personnel, and facts management) and enrollment processes [19]. In addition, several research appear to indicate a decrease in realized access to services [20,21], and point to substantial 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 services, for example geographic accessibility and high-quality of care [26,30]. In 2005, the maternal mortality price, an indicator that’s sensitive towards the overall healthcare system, was 130/100.000 in Colombia, in comparison with 30/ one hundred.000 in Costa Rica, even though per capita 2004 health expenditure were 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 Solutions Investigation 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, readily available proof points to failures in the condition sine qua non for the thriving implementation of managed competition, as outlined by its supporters [1]: the existence of an efficient regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their potential to manage an excellent variety of institutions related to insufficient monetary resources, lack of control mechanisms and excessive, and in some cases contradictory, regulation norms. Most research of the determinants of use of care in Colombia focus on private variables and initial contact with solutions, and ignore contextual variables health policy and qualities of healthcare solutions. Insurance coverage, measured only by enrolment rate, is often viewed as an independent variable, while in managed competition models, insurers directly influence the provider networks and situations of access to healthcare [36]. In addition, small analysis 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, on account of methodological issues in like 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, from the viewpoint of social actors.Strategies There had been two Locations of Study: one urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Department of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Inside the former, a wide array of insurers are present, though inside the latter only 1 subsidized insurance organization, using the majority with the contributory insurance enrollees getting affiliated in two insurance coverage businesses. In both places most of the population live in poverty [42]. Within the urban location, the coverage from the subsidized regime is slightly much less than in the rural a.
