Asymmetry in Cost Behavior in Brazilian Hospitals

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Dear Author,

I was invited to review the article entitled "Asymmetry in Cost Behavior in Brazilian Hospitals”. The aim of the paper is to Investigate if the proportion of fixed assets over total assets is positively 3 associated with the asymmetric cost behavior of public and private hospitals in Brazil, using a sample of 101 hospitals, spread over the 2010-2019 period.

It is with great pleasure that I accept the review and hope to be able to contribute with knowledge. I would like to indicate some aspects to improve and questions that arise, explained below:

References

In general, in bibliographic references it is necessary to carry out a global review, there are referencing problems at various levels, for example:

·       missing names of authors: BANKER, Rajiv D. et al. The effects of digital trading platforms on commodity prices in agricultural supply 477 chains. MIS quarterly, p. 599-611, 2011 and, ZHU, G. et al. The influence of corporate financialization on asymmetric cost behavior: weakening or 573 worsening. Journal of Business Economics and Management, v. 22, n. 1, p. 21-41, 2021.

·       some references format does not comply with the stipulations of journal;

·       wrong title and incomplete reference; HOMBURG, Carsten; HOPPE, André; SCHICK, Roman. (2018). How Payout Policy Relates to Asymmetric

line 40 – must be Noreen and not Norren;

line 71 – using 2003B (why?) and Alakrishnan et al., 2004 or (2107)? line 126 - Jiang & Hu, 2016), is missing an author.

It is needed to review references in text, it is not adequate to use references in uppercase (see: page 5 and 6)

Section 3 Research Metodology

Figure 1 does not demonstrate the study to be developed, it remains to be explained why the NSR and SPC variables are used, and from the figure only "smaller fixed assets" are related to "ciost asymmetry". Is it the design of the present study or that of other authors? what is the "cutoff" value between "larger" and "smaller" fixed assets?

Figure 1 should be presented after explaining all the variables used. Source: Prepared by the authors (2022). Why 2022?

line 207: box 1 – present variables used in the study - How are the following variables used: SPC, AE, SE, for example? explain.

Section 4. Results and discussion

Table 4 and 5 must be improve, there is missing data.

what results and discussion for hypothesis H2? any results?

 

Section 5. Final Considerations

The title of section 5 should be “conclusions”

The limitations of the investigation are not presented.

 

The recommendations/questions presented are intended to alert author about methodological and scientific aspects that should be present in the investigation.

I hope I have contributed to the improvement of the manuscript, and I wish the authors success in their future investigations.

Comments for author File: Comments.pdf

Author Response

eport and Letter to Editors and Reviewers

Manuscript ID: jrfm-3025983

Type of manuscript: Article

Title: Asymmetry in cost behavior in Brazilian hospitals

Authors: Josiane Da Conceição Bitela Da Silva, Tany Ingrid Sagredo Marin, Katia Abbas, Luiz Eduardo Gaio, Carlos Alberto Grespan Bonacim, Rafael Confetti Gatsios.

 

Dear Editors and Reviewers Journal of Risk and Financial Management- JRFM,

We appreciate the opportunity to resubmit the manuscript for further evaluation by the referees. Furthermore, we would like to express our sincere thanks to those evaluated, who offered criticisms and suggestions that certainly made it possible to considerably improve our study.

Below we present a report with the changes made to the revised version. We believe we have adjusted all requests.

Yours sincerely,

The authors

Author Response File: Author Response.pdf

Reviewer 2 Report

Comments and Suggestions for Authors

To increase the clarity of the paper, authors should include more details about the adjustment cost concept and the theory underlying it (see the theory of investment in capital by the individual firm). Authors may consider reading Haavelmo, T. 1960. A study in the theory of investment. Chicago: University of Chicago Press.

Two concepts asymmetric costs and adjustment cost are used somehow interchangeable. Authors need to clarify the meaning of each concept and to use them accordingly to that meaning.

Other relevant reference:   Hoffmann, Kira (2017). Cost Behavior: An Empirical Analysis of Determinants and Consequences of Asymmetries, PhD Series, No. 6.2017, ISBN 9788793483859, Copenhagen Business School (CBS), Frederiksberg, https://hdl.handle.net/10398/9449

 It is necessary to link the variable measured as the proportion of fixed assets over total assets to a concept related to cost asymmetry or cost adjustment. Present this concept from the beginning of the paper, including the abstract.

 Authors need to clarify some inconsistencies in their paper. For example, in the first hypothesis (H1. The proportion of fixed assets over total assets is positively associated with the asymmetric cost behavior of hospitals.) reader is lead to think to 2 variables (proportion of fixed assets over total assets & asymmetric cost behaviour), while later on, in the same paragraph, the authors state: “we measured asymmetry by the proportion of fixed assets over total assets”, that indicate that the two variables referred to in H1 seem to be the same as referred to the H2…Later on the fixed assets are introduced as a control variable…Then, the value of assets is presented both as group delimitator and at the same time as variable (“…a group of hospitals with higher representativeness of fixed assets and another group with lower investments in this asset group to investigate the relationship between investment and cost asymmetry”)

 Muchmore, the objective stated at the beginning of Research method section (“analyzing the cost behavior of hospitals regarding the variation in revenues”) is not related to the 2 research hypotheses previously mentioned.

 In Figure 1 the NSR and SPC are not defined nor explained.

The model proposed by Anderson, Banker, and Janakiraman (2003) is not appropriate to answer the two research hypotheses. It does not include in any way the fixed assets or their ratio to total assets.

Better support and present statements as: “The Chow and Hausman tests were used to fit the relationships between variables to 253 the models and improve the fit of the models. Autocorrelation and heteroscedasticity tests 254 were conducted to ensure the validity of the results”. Maybe, authors may provide some synthesized results in an appendix and refer to it in the text.

Model (2) needs to pe presented explicitly in terms of dependent, independent and control variables.

 The three variables presented in the descriptive statistics (from the Results) are not consistent with the variables described and referred to in the Research methodology (authors need to link the Anderson et al., 20003) model to their own econometric model.

Similarly, the results (Tables 4 and 5) do not include the variable(s) related to fixed assets, as stated at the beginning of the paper.

 Moreover, additional arguments and explanations need to be presented as related to the econometric model, as for example why the random effects regression was used and not the fixed effects regression.

The way the results are presented, it seems that a comparative analysis based on independent t-test could be much more appropriate.

The template of the journal is not entirely considered.

Author Response

eport and Letter to Editors and Reviewers

Manuscript ID: jrfm-3025983

Type of manuscript: Article

Title: Asymmetry in cost behavior in Brazilian hospitals

Authors: Josiane Da Conceição Bitela Da Silva, Tany Ingrid Sagredo Marin, Katia Abbas, Luiz Eduardo Gaio, Carlos Alberto Grespan Bonacim, Rafael Confetti Gatsios.

 

Dear Editors and Reviewers Journal of Risk and Financial Management- JRFM,

We appreciate the opportunity to resubmit the manuscript for further evaluation by the referees. Furthermore, we would like to express our sincere thanks to those evaluated, who offered criticisms and suggestions that certainly made it possible to considerably improve our study.

Below we present a report with the changes made to the revised version. We believe we have adjusted all requests.

Yours sincerely,

The authors

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Comments and Suggestions for Authors

I agree with the revised version provided by the authors, which includes all suggestions.

Much success for future investigations.

Author Response

Report and Letter to Editors and Reviewers – Round 2

Manuscript ID: jrfm-3025983

Type of manuscript: Article

Title: Asymmetry in cost behavior in Brazilian hospitals

Authors: Josiane Da Conceição Bitela Da Silva, Tany Ingrid Sagredo Marin, Katia Abbas, Luiz Eduardo Gaio, Carlos Alberto Grespan Bonacim, Rafael Confetti Gatsios.

 

Dear Editors and Reviewers Journal of Risk and Financial Management- JRFM,

We appreciate the opportunity to resubmit the manuscript for further evaluation by the referees. Furthermore, we would like to express our sincere thanks to those evaluated, who offered criticisms and suggestions that certainly made it possible to considerably improve our study.

Below we present a report with the changes made to the revised version (round 2). We believe we have adjusted all requests.

Yours sincerely,

The authors

Author Response File: Author Response.docx

Reviewer 2 Report

Comments and Suggestions for Authors

Authors should have included more details about the adjustment cost concept and the theory underlying it (see the theory of investment in capital by the individual firm). Authors should have been clarified the meaning of the two concepts asymmetric costs and adjustment cost, used somehow interchangeable. 

The variable measured as the proportion of fixed assets over total assets  hasnțt been linked to a concept related to cost asymmetry or cost adjustment.  

Muchmore, the objective stated at the beginning of Research method section (“analyzing the cost behavior of hospitals regarding the variation in revenues”) is not related to the 2 research hypotheses previously mentioned.

Better support and present autocorrelation and heteroscedasticity tests, authors may provide some synthesized results in an appendix and refer to it in the text.

 

 

Author Response

Report and Letter to Editors and Reviewers – Round 2

Manuscript ID: jrfm-3025983

Type of manuscript: Article

Title: Asymmetry in cost behavior in Brazilian hospitals

Authors: Josiane Da Conceição Bitela Da Silva, Tany Ingrid Sagredo Marin, Katia Abbas, Luiz Eduardo Gaio, Carlos Alberto Grespan Bonacim, Rafael Confetti Gatsios.

 

Dear Editors and Reviewers Journal of Risk and Financial Management- JRFM,

We appreciate the opportunity to resubmit the manuscript for further evaluation by the referees. Furthermore, we would like to express our sincere thanks to those evaluated, who offered criticisms and suggestions that certainly made it possible to considerably improve our study.

Below we present a report with the changes made to the revised version (round 2). We believe we have adjusted all requests.

Yours sincerely,

The authors

Author Response File: Author Response.pdf

Round 3

Reviewer 2 Report

Comments and Suggestions for Authors

The changes in the last version could be considered as improvements of the paper. It is publishable, however, I still consider that more improvements need to be included in order to be considered a top quality paper.

Author Response

Report and Letter to Editors and Reviewers – Round 3

Manuscript ID: jrfm-3025983

Type of manuscript: Article

Title: Asymmetry in cost behavior in Brazilian hospitals

Authors: Josiane Da Conceição Bitela Da Silva, Tany Ingrid Sagredo Marin, Katia Abbas, Luiz Eduardo Gaio, Carlos Alberto Grespan Bonacim, Rafael Confetti Gatsios.

 

Dear Editors and Reviewers Journal of Risk and Financial Management- JRFM,

We appreciate the opportunity to resubmit the manuscript for further evaluation by the referees. Furthermore, we would like to express our sincere thanks to those evaluated, who offered criticisms and suggestions that certainly made it possible to considerably improve our study.

Below we present a report with the changes made to the revised version (round 3). We believe we have adjusted all requests.

Yours sincerely,

The authors

Author Response File: Author Response.docx