Access to care [9,10]. Having said that, it hasbeen a long, complicated approach, and the final results are controversial [11,12]. In spite on the considerable enhance in public overall health expenditure from 3 to six.six of GDP, more than the 1993 to 2007 period [13], about 15.three to 19.3 with the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime [15] that covers a range of solutions (POS-S) drastically inferior to that supplied by the contributory one [16,17]. Roughly 17 of well being expenditure is devoted to administrative expenses [18], of which more than 50 is spent on supporting daily operations (economic, personnel, and information management) and enrollment processes [19]. In addition, quite a few research seem to indicate a decrease in realized access to services [20,21], and point to significant barriers associated to qualities of population, such PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20433742 as insurance coverage enrolment [22-28], earnings [22,25,26,28], education [22-27,29] and, characteristics of services, for example geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality rate, an indicator which is sensitive for the overall healthcare method, was 130/100.000 in Colombia, compared to 30/ one hundred.000 in Costa Rica, alBFH772 site though per capita 2004 overall health expenditure have been comparable (USD 549 and USD 598, respectively) but a GNP per capita decrease in the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Health Services Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, accessible proof points to failures within the situation sine qua non for the productive implementation of managed competitors, in line with its supporters [1]: the existence of an efficient regulatory technique. These studies [32-35] reveal deficiencies in regulation authorities in their capability to handle a terrific variety of institutions related to insufficient financial sources, lack of handle mechanisms and excessive, and at times contradictory, regulation norms. Most research of your determinants of use of care in Colombia concentrate on private variables and initial get in touch with with solutions, and ignore contextual variables wellness policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment rate, is usually viewed as an independent variable, while in managed competition models, insurers directly influence the provider networks and circumstances of access to healthcare [36]. Furthermore, small study has evaluated access in the point of view from the social actors [26,37-39], despite the restricted capacity of quantitative models in explaining determinants of use of care, as a result of methodological issues in like contextual variables [40,41]. The objective of this article is usually to contribute for the improvement of our understanding with the aspects influencing access for the continuum of healthcare services in the Colombian managed competitors model, in the perspective of social actors.Approaches There were two Places 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. Within the former, a wide array of insurers are present, even though within the latter only one particular subsidized insurance coverage enterprise, with all the majority of your contributory insurance coverage enrollees getting affiliated in two insurance organizations. In each regions the majority of the population live in poverty [42]. Within the urban region, the coverage of the subsidized regime is slightly less than inside the rural a.
