Disease rate as an artifact of the health care system: Tubercolosis in Puerto Rico

Abstract

It is demonstrated that the reported rates of tubercolosis in Puerto Rico comprise a direct, positive measurement of location, infrastructure and numbers of personnel in the health care system. The disease map does not reflect true geographic prevalence, but it is a measurable artifact of the health care system. Areas of high and low reporting and zones of minimum patient contact, are identified in the interests of program management.