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They provide evidence to question the promotion of the managed competition model in low and middle-income countries.
The case study provides extensive information about the phenomenon - access to care in the managed competition model in Colombia - based on individual cases [ 45, 46].
The study's objective is to improve our understanding of the factors influencing access to the continuum of care in the Colombian managed competition model, from the social actors' point of view.
The objective of this article is to contribute to the improvement of our understanding of the factors influencing access to the continuum of healthcare services in the Colombian managed competition model, from the perspective of social actors.
Colombia has its General System of Social Security in Health (SGSSS), a managed competition model made up of two different insurance schemes: contributory for formal sector employees and those able to pay, and subsidized for the low income population [ 30].
A managed competition model was introduced in which health insurers play a central role; health insurance companies were expected to act more as contracting parties, demanding effective, high quality services.
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Insurance coverage, measured only by enrolment rate, is often viewed as an independent variable, although in managed competition models, insurers directly influence the provider networks and conditions of access to healthcare [ 36].
A tenet of the Dutch model of managed competition is consumer choice of purchaser.
The Dutch reforms are based on a mandatory health insurance system for all Dutch citizens combined with a model of managed competition for hospitals [ 16].
Matching the strengths of this model would be vital for managed competition in Ireland.
In Ireland, by contrast, the institutional framework for managed competition is less developed.
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