Access to care [9,10]. Nonetheless, it hasbeen a long, complicated course of action, plus the outcomes are controversial [11,12]. In spite on the important improve in public overall health expenditure from 3 to six.6 of GDP, over the 1993 to 2007 period , around 15.3 to 19.3 in the population remains uninsured [14,15]; and 38.7 are insured under the subsidized regime  that covers a variety of services (POS-S) drastically inferior to that offered by the contributory a single [16,17]. About 17 of health expenditure is devoted to administrative costs , of which greater than 50 is spent on supporting TPOP146 web day-to-day operations (economic, personnel, and info management) and enrollment processes . Additionally, many research appear to indicate a reduce in realized access to solutions [20,21], and point to significant barriers connected 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 services, like geographic accessibility and quality of care [26,30]. In 2005, the maternal mortality rate, an indicator that is definitely sensitive to the overall healthcare method, was 130/100.000 in Colombia, in comparison to 30/ 100.000 in Costa Rica, whilst per capita 2004 overall health expenditure were related (USD 549 and USD 598, respectively) but a GNP per capita reduced within the former (USD 6130 and USD 9220) .Vargas et al. BMC Well being Solutions Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page three ofIn addition, readily available evidence points to failures within the condition sine qua non for the thriving implementation of managed competition, as outlined by its supporters : the existence of an effective regulatory method. These studies [32-35] reveal deficiencies in regulation authorities in their capability to control an excellent variety of institutions associated to insufficient monetary resources, lack of handle mechanisms and excessive, and often contradictory, regulation norms. Most studies in the determinants of use of care in Colombia focus on personal variables and initial speak to with services, and ignore contextual variables well being policy and traits of healthcare solutions. Insurance coverage, measured only by enrolment rate, is usually viewed as an independent variable, even though in managed competitors models, insurers directly influence the provider networks and circumstances of access to healthcare . Also, little research has evaluated access in the point of view on the social actors [26,37-39], in spite of the restricted capacity of quantitative models in explaining determinants of use of care, resulting from methodological troubles in which includes contextual variables [40,41]. The objective of this article is usually to contribute to the improvement of our understanding in the aspects influencing access towards the continuum of healthcare solutions inside the Colombian managed competitors model, from the viewpoint of social actors.Techniques There have been two Places of Study: a single urban (Ciudad Bol ar, Bogot? D.C.) and one rural (La Cumbre, Division of Valle del Cauca) with 628.672  and 11.122 inhabitants  respectively. Within the former, a wide array of insurers are present, though in the latter only a single subsidized insurance coverage firm, using the majority with the contributory insurance enrollees being affiliated in two insurance coverage organizations. In each locations the majority of the population live in poverty . Within the urban location, the coverage on the subsidized regime is slightly significantly less than inside the rural a.