%PDF-1.6 % 1 0 obj <> endobj 2 0 obj <>stream Ada Kwan, Benjamin Daniels, Vaibhav Saria, Srinath Satyanarayana, Ramnath Subbaraman, Andrew McDowell, Sofi Bergkvist, Ranendra K. Das, Veena Das, Jishnu Das, Madhukar Pai Variations in the quality of tuberculosis care in urban India: A cross-sectional, standardized patient study in two cities www.plosmedicine.org www.plosmedicine.org endstream endobj 3 0 obj <>/XObject<>>>/CropBox[0 0 612 792]/MediaBox[0 0 612 792]/Parent 13 0 R/Annots 14 0 R/Contents 15 0 R/TrimBox[0 0 612 792]>> endobj 11 0 obj <> endobj 16 0 obj <> endobj 17 0 obj <>stream %!PS-AdobeFont-1.0 %%This font is a conversion from Helvetica-Oblique with the following copyright notice: %Copyright (c) 1985, 1987, 1989, 1990, 1997, 1998, 1999 Adobe Systems Incorporated. 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(approximately)Tj 6.3735 0 Td (75%)Tj 2.202 0 Td (of)Tj 1.0444 0 Td (the)Tj 1.5934 0 Td (time.)Tj 2.3691 0 Td (The)Tj 1.9276 0 Td (SP)Tj 1.5516 0 Td (method)Tj 3.5209 0 Td (has)Tj 1.8141 0 Td (limitations:)Tj 4.8875 0 Td (it)Tj 0.7102 0 Td (cannot)Tj -36.5041 -1.474 Td (account)Tj 3.682 0 Td (for)Tj 1.3785 0 Td (patient)Tj 3.1867 0 Td (mix)Tj 1.7605 0 Td (or)Tj 1.0981 0 Td (care-management)Tj 8.2532 0 Td (practices)Tj 4.1774 0 Td (reflecting)Tj 4.2251 0 Td (more)Tj 2.4766 0 Td (than)Tj 2.1423 0 Td (one)Tj 1.8679 0 Td (patient)Tj -34.2483 -1.474 Td (provider)Tj 3.7834 0 Td (interaction.)Tj ET Q q 1 j 1 J 0 w 11.4998 0 0 11.4998 200.0125 386.7023 cm BT /F2 1 Tf 1 TL -0.0035 Tc 0 0 Td (Conclusions)Tj ET Q q 1 j 1 J 0 w 9.5 0 0 9.5 200.0125 369.7511 cm BT /F0 1 Tf 1 TL -0.0042 Tc 0 0 Td (Quality)Tj 3.3001 0 Td (of)Tj 1.0443 0 Td (TB)Tj 1.4919 0 Td (care)Tj 2.1484 0 Td (is)Tj 0.9309 0 Td (suboptimal)Tj 4.995 0 Td (and)Tj 1.8678 0 Td (variable)Tj 3.6701 0 Td (in)Tj 0.9847 0 Td (urban)Tj 2.7451 0 Td (India's)Tj 3.0674 0 Td (private)Tj 3.1867 0 Td (health)Tj 2.9063 0 Td (sector.)Tj 3.1927 0 Td (Address-)Tj -35.5314 -1.474 Td (ing)Tj 1.5336 0 Td (this)Tj 1.7545 0 Td (is)Tj 0.931 0 Td (critical)Tj 3.0136 0 Td (for)Tj 1.3786 0 Td (India's)Tj 3.0674 0 Td (plans)Tj 2.578 0 Td (to)Tj 1.0443 0 Td (end)Tj 1.8679 0 Td (TB)Tj 1.4979 0 Td (by)Tj 1.2651 0 Td (2025.)Tj 2.6914 0 Td (For)Tj 1.7068 0 Td (the)Tj 1.5933 0 Td (first)Tj 1.8202 0 Td (time,)Tj 2.3691 0 Td (we)Tj 1.48 0 Td (have)Tj 2.3632 0 Td (rich)Tj 1.8142 0 Td (mea-)Tj -35.7701 -1.474 Td (sures)Tj 2.6377 0 Td (on)Tj 1.3188 0 Td (representative)Tj 6.4809 0 Td (levels)Tj 2.7451 0 Td (of)Tj 1.0443 0 Td (care)Tj 2.1424 0 Td (quality)Tj 3.0734 0 Td (from)Tj 2.202 0 Td (2)Tj 0.7699 0 Td (cities,)Tj 2.7451 0 Td (which)Tj 2.7451 0 Td (can)Tj 1.8142 0 Td (inform)Tj 2.9719 0 Td (private-sector)Tj -32.6908 -1.474 Td (TB)Tj 1.4919 0 Td (interventions)Tj 5.8184 0 Td (and)Tj 1.8679 0 Td (quality-improvem)Tj 7.5312 0 Td (ent)Tj 1.5933 0 Td (efforts.)Tj ET Q q 1 j 1 J 0 w 11.9999 0 0 11.9999 209.9905 271.2188 cm BT /F0 1 Tf 1 TL -0.0033 Tc 0 0 Td (Author)Tj 3.137 0 Td (summary)Tj ET Q q 1 j 1 J 0 w 11.4998 0 0 11.4998 209.9905 241.2283 cm BT /F2 1 Tf 1 TL -0.0035 Tc 0 0 Td (Why)Tj 2.3219 0 Td (was)Tj 2.0952 0 Td (this)Tj 1.9868 0 Td (study)Tj 2.8691 0 Td (done?)Tj ET Q q 1 j 1 J 0 w 10 0 0 10 209.9905 219.2314 cm BT /F6 1 Tf 1 TL -0.004 Tc 0 0 Td ()Tj 0.7823 0 Td (India)Tj 2.3357 0 Td (accounts)Tj 3.7474 0 Td (for)Tj 1.3833 0 Td (a)Tj 0.6577 0 Td (quarter)Tj 3.1521 0 Td (of)Tj 1.0148 0 Td (the)Tj 1.4683 0 Td (world's)Tj 3.1294 0 Td (estimated)Tj 4.0762 0 Td (10.4)Tj 1.8709 0 Td (million)Tj 3.1237 0 Td (new)Tj 1.8766 0 Td (tuberculosis)Tj 5.0399 0 Td (\(TB\))Tj -32.876 -1.2982 Td (cases)Tj 2.2224 0 Td (per)Tj 1.5307 0 Td (year,)Tj 2.1316 0 Td (nearly)Tj 2.6986 0 Td (a)Tj 0.6519 0 Td (third)Tj 2.211 0 Td (of)Tj 1.0148 0 Td (the)Tj 1.474 0 Td (1.7)Tj 1.3947 0 Td (million)Tj 3.1237 0 Td (annual)Tj 2.9594 0 Td (TB)Tj 1.4116 0 Td (deaths,)Tj 3.0161 0 Td (and)Tj 1.7291 0 Td (a)Tj 0.652 0 Td (third)Tj 2.2166 0 Td (of)Tj 1.0148 0 Td (the)Tj 1.4684 0 Td (esti-)Tj -32.9214 -1.3039 Td (mated)Tj 2.7212 0 Td (4)Tj 0.6974 0 Td (million)Tj 3.1237 0 Td (missing)Tj 3.7021 0 Td (patients)Tj 3.7587 0 Td (who)Tj 1.9389 0 Td (are)Tj 1.4513 0 Td (either)Tj 2.5285 0 Td (not)Tj 1.576 0 Td (diagnosed)Tj 4.2803 0 Td (or)Tj 1.0998 0 Td (are)Tj 1.4457 0 Td (not)Tj 1.5761 0 Td (reported)Tj 3.6566 0 Td (to)Tj -33.5563 -1.2983 Td (national)Tj 3.5036 0 Td (TB)Tj 1.4117 0 Td (programs.)Tj -5.6976 -1.8992 Td ()Tj 0.7823 0 Td (The)Tj 1.7802 0 Td (private)Tj 2.9877 0 Td (health)Tj 2.6815 0 Td (sector)Tj 2.6022 0 Td (provides)Tj 3.651 0 Td (the)Tj 1.4683 0 Td (bulk)Tj 1.9956 0 Td (of)Tj 1.0148 0 Td (primary)Tj 3.4583 0 Td (care)Tj 1.8708 0 Td (in)Tj 1.0375 0 Td (India,)Tj 2.5625 0 Td (serving)Tj 3.1124 0 Td (as)Tj 1.0148 0 Td (the)Tj 1.4683 0 Td (first)Tj -32.7059 -1.2983 Td (point)Tj 2.3584 0 Td (of)Tj 1.0148 0 Td (contact)Tj 3.1521 0 Td (for)Tj 1.389 0 Td (50%)Tj 1.9275 0 Td (to)Tj 1.0262 0 Td (70%)Tj 1.9275 0 Td (of)Tj 1.0148 0 Td (patients)Tj 3.3676 0 Td (with)Tj 1.9955 0 Td (TB)Tj 1.4117 0 Td (symptoms.)Tj 4.5864 0 Td (The)Tj 1.7801 0 Td (private)Tj 2.9877 0 Td (sector)Tj 2.6022 0 Td (com-)Tj -32.5415 -1.3039 Td (prises)Tj 2.5228 0 Td (a)Tj 0.652 0 Td (wide)Tj 2.1203 0 Td (range)Tj 2.4661 0 Td (of)Tj 1.0148 0 Td (qualification)Tj 5.2327 0 Td (levels:)Tj 2.6022 0 Td (allopathic)Tj 4.1216 0 Td (providers)Tj 4.0195 0 Td (with)Tj 2.0012 0 Td (Bachelor)Tj 3.7304 0 Td (of)Tj 1.0148 0 Td (Medi-)Tj -31.4984 -1.2982 Td (cine,)Tj 2.109 0 Td (Bachelor)Tj 3.7303 0 Td (of)Tj 1.0148 0 Td (Surgery)Tj 3.3109 0 Td (\(MBBS\))Tj 3.4299 0 Td (or)Tj 1.0998 0 Td (higher)Tj 2.8006 0 Td (degrees;)Tj 3.4413 0 Td (Ayurveda,)Tj 4.3199 0 Td (Yoga,)Tj 2.4888 0 Td (Unani,)Tj 2.9764 0 Td (Siddha,)Tj 3.2088 0 Td (or)Tj -33.9305 -1.2983 Td (Homeopathy)Tj 5.4765 0 Td (\(AYUSH\))Tj 4.1953 0 Td (practitioners)Tj 5.312 0 Td (\(practitioners)Tj 5.6466 0 Td (with)Tj 1.9956 0 Td (degrees)Tj 3.2145 0 Td (in)Tj 1.0374 0 Td (alternative)Tj 4.4221 0 Td (medicine)Tj -31.3 -1.3039 Td (or)Tj 1.0998 0 Td (traditional)Tj 4.4164 0 Td (systems)Tj 3.2995 0 Td (of)Tj 1.0148 0 Td (health\);)Tj 3.2428 0 Td (and)Tj 1.7348 0 Td (providers)Tj 4.0195 0 Td (with)Tj 1.9956 0 Td (other)Tj 2.3471 0 Td (or)Tj 1.0998 0 Td (no)Tj 1.2756 0 Td (formal)Tj 2.8856 0 Td (qualifications,)Tj -28.4313 -1.2983 Td (who)Tj 1.9389 0 Td (are)Tj 1.4513 0 Td (known)Tj 3.0047 0 Td (to)Tj 1.0205 0 Td (provide)Tj 3.2938 0 Td (a)Tj 0.652 0 Td (large)Tj 2.16 0 Td (proportion)Tj 4.6318 0 Td (of)Tj 1.0148 0 Td (primary)Tj 3.4525 0 Td (care.)Tj ET Q q 1 j 1 J 0 w 576 737.1 m 36 737.1 l 36 737.6 l 576 737.6 l f* 36 741.2598 134.7591 23.6976 re W* n q 134.7024 0 0 23.6409 36 741.3165 cm q /I0 Do Q Q Q q 0 0 612 792 re W* n 1 j 1 J 0 w 7.9999 0 0 7.9999 434.0409 745.7952 cm BT /F0 1 Tf 1 TL -0.005 Tc 0 0 Td (Quality)Tj 3.2811 0 Td (of)Tj 1.0417 0 Td (tubercul)Tj 3.4867 0 Td (osis)Tj 1.9701 0 Td (care)Tj 2.126 0 Td (in)Tj 0.9779 0 Td (urban)Tj 2.7355 0 Td (India)Tj ET Q q 1 j 1 J 0 w 36 48.0002 m 576 48.0002 l 576 47.5002 l 36 47.5002 l f* 0.83 0.64 0.02 0 k 95.811 34.9228 m 254.3811 34.9228 l h f* 0 g 7.9999 0 0 7.9999 36 36 cm BT /F0 1 Tf 1 TL -0.005 Tc 0 0 Td (PLOS)Tj 2.8559 0 Td (Medicine)Tj 4.1457 0 Td (|)Tj 0.83 0.64 0.02 0 k 0.4748 0 Td (https://doi.or)Tj 5.4142 0 Td (g/10.1371/)Tj 4.6418 0 Td (journal.pmed.1)Tj 6.4984 0 Td (002653)Tj 0 g 4.2662 0 Td (September)Tj 5.0386 0 Td (25,)Tj 1.5875 0 Td (2018)Tj 30.2175 0 Td (2)Tj 0.7654 0 Td (/)Tj 0.496 0 Td (22)Tj /F9 1 Tf -0.025 Tc -66.402 84.0904 Td (Foundation)Tj 4.3512 0 Td (via)Tj 1.2543 0 Td (the)Tj 1.3748 0 Td (Arcady)Tj 2.7851 0 Td (group)Tj 2.4236 0 Td (\(OPP115466)Tj 4.7835 0 Td (5\))Tj -16.9725 -1.3748 Td (and)Tj 1.5874 0 Td (a)Tj 0.6449 0 Td (Doris)Tj 2.1968 0 Td (Duke)Tj 2.126 0 Td (Clinical)Tj 2.8347 0 Td (Scientist)Tj 3.3803 0 Td (Developmen)Tj 4.6418 0 Td (t)Tj -17.4119 -1.3749 Td (Award,)Tj 2.8134 0 Td (and)Tj 1.5874 0 Td (acknowledg)Tj 4.4079 0 Td (es)Tj 1.063 0 Td (prior)Tj 1.9772 0 Td (support)Tj 3.0968 0 Td (from)Tj 2.0127 0 Td (a)Tj -16.9584 -1.3748 Td (Harvard)Tj 3.1606 0 Td (Center)Tj 2.6221 0 Td (for)Tj 1.2543 0 Td (AIDS)Tj 2.1189 0 Td (Researc)Tj 2.9977 0 Td (h)Tj -12.1536 -1.3748 Td (\(5P30AI060)Tj 4.4504 0 Td (354-13\))Tj 3.2032 0 Td (and)Tj 1.5874 0 Td (a)Tj 0.6449 0 Td (Harvard)Tj 3.1606 0 Td (Catalyst)Tj 3.1323 0 Td (KL2/)Tj -16.1788 -1.3748 Td (CMERIT)Tj 3.2882 0 Td (Award)Tj 2.5866 0 Td (\(KL2)Tj 1.9984 0 Td (TR001100\).)Tj 4.656 0 Td (MP)Tj 1.4953 0 Td (is)Tj 0.8362 0 Td (a)Tj 0.6449 0 Td (recipient)Tj -15.5056 -1.3748 Td (of)Tj 0.9496 0 Td (a)Tj 0.6378 0 Td (Tier)Tj 1.6157 0 Td (1)Tj 0.6945 0 Td (Canada)Tj 2.9552 0 Td (Research)Tj 3.6992 0 Td (Chair)Tj 2.1402 0 Td (from)Tj 2.0126 0 Td (Canadi)Tj 2.5016 0 Td (an)Tj -17.2064 -1.3748 Td (Institutes)Tj 3.6425 0 Td (of)Tj 0.9496 0 Td (Health)Tj 2.5725 0 Td (Research.)Tj 3.9189 0 Td (The)Tj 1.5945 0 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3.352 0 Td (of)Tj -17.6883 -1.3748 Td (the)Tj 1.3677 0 Td (Editorial)Tj 3.2032 0 Td (Boards)Tj 2.8417 0 Td (of)Tj 0.9496 0 Td (PLOS)Tj 2.3315 0 Td (Medicine)Tj 3.5717 0 Td (and)Tj 1.5874 0 Td (PLOS)Tj -15.8528 -1.3748 Td (ONE)Tj 1.8708 0 Td (and)Tj 1.5874 0 Td (is)Tj 0.8363 0 Td (also)Tj 1.7291 0 Td (an)Tj 1.1126 0 Td (editor)Tj 2.3457 0 Td (of)Tj 0.9496 0 Td (the)Tj 1.3678 0 Td (PLOS)Tj 2.3315 0 Td (Tuberculosi)Tj 4.3228 0 Td (s)Tj -18.4536 -1.3748 Td (Channel.)Tj 3.4228 0 Td (MP)Tj 1.5024 0 Td (previously)Tj 4.0181 0 Td (served)Tj 2.6859 0 Td (as)Tj 1.063 0 Td (a)Tj 0.6449 0 Td (consultant)Tj 4.0819 0 Td (to)Tj -17.419 -1.3748 Td (the)Tj 1.3677 0 Td (Bill)Tj 1.3252 0 Td (&)Tj 0.8646 0 Td (Melind)Tj 2.5016 0 Td (a)Tj 0.6448 0 Td (Gates)Tj 2.3245 0 Td (Foundation.)Tj 4.578 0 Td (The)Tj 1.5874 0 Td (other)Tj -15.1938 -1.3749 Td (authors)Tj 3.0472 0 Td (have)Tj 1.9559 0 Td (no)Tj 1.1693 0 Td (competing)Tj 4.1599 0 Td (interes)Tj 2.4874 0 Td (ts)Tj 0.9 0 Td (to)Tj 0.9497 0 Td (declare.)Tj 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2000 Adobe Systems Incorporated. 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