Access to care [9,10]. Nevertheless, it hasbeen a lengthy, complicated process, as well as the results are controversial [11,12]. In spite from the significant enhance in public health expenditure from three to six.6 of GDP, over the 1993 to 2007 period [13], about 15.3 to 19.3 in the population remains uninsured [14,15]; and 38.7 are insured below the subsidized regime [15] that covers a range of ML-18 price services (POS-S) greatly inferior to that provided by the contributory a single [16,17]. About 17 of overall health expenditure is devoted to administrative fees [18], of which greater than 50 is spent on supporting everyday operations (economic, personnel, and info management) and enrollment processes [19]. In addition, a number of studies seem to indicate a reduce in realized access to services [20,21], and point to important barriers associated to qualities 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, including geographic accessibility and excellent of care [26,30]. In 2005, the maternal mortality price, an indicator that is sensitive towards the overall healthcare program, was 130/100.000 in Colombia, when compared with 30/ one hundred.000 in Costa Rica, when per capita 2004 health expenditure were similar (USD 549 and USD 598, respectively) but a GNP per capita reduced within the former (USD 6130 and USD 9220) [31].Vargas et al. BMC Wellness Solutions Analysis 2010, 10:297 http://www.biomedcentral.com/1472-6963/10/Page 3 ofIn addition, obtainable proof points to failures within the condition sine qua non for the productive implementation of managed competitors, in line with its supporters [1]: the existence of an effective regulatory technique. These studies [32-35] reveal deficiencies in regulation authorities in their ability to handle an incredible quantity of institutions connected to insufficient economic sources, lack of handle mechanisms and excessive, and in some cases contradictory, regulation norms. Most research on the determinants of use of care in Colombia concentrate on personal variables and initial make contact with with services, and ignore contextual variables well being policy and traits of healthcare services. Insurance coverage coverage, measured only by enrolment rate, is usually viewed as an independent variable, while in managed competitors models, insurers straight influence the provider networks and circumstances of access to healthcare [36]. Also, tiny research has evaluated access in the point of view of the social actors [26,37-39], despite the limited capacity of quantitative models in explaining determinants of use of care, as a result of methodological issues in which includes contextual variables [40,41]. The objective of this article is to contribute towards the improvement of our understanding on the aspects influencing access for the continuum of healthcare services within the Colombian managed competition model, from the perspective of social actors.Methods There have been two Regions of Study: one particular urban (Ciudad Bol ar, Bogot? D.C.) and one particular rural (La Cumbre, Division of Valle del Cauca) with 628.672 [42] and 11.122 inhabitants [43] respectively. Inside the former, a wide array of insurers are present, even though inside the latter only 1 subsidized insurance coverage organization, together with the majority of your contributory insurance coverage enrollees getting affiliated in two insurance firms. In both areas the majority of the population reside in poverty [42]. In the urban location, the coverage with the subsidized regime is slightly less than in the rural a.
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