Public Health System and Socio-Economic Development Coupling Based on Systematic Theory: Evidence from China

Round 1

Reviewer 1 Report

Comments to the Author

I enjoyed reading this paper. Thanks. The authors introduce very relevant and timely topics, particularly after the COVID-19 pandemic implications where public health systems worldwide are undergoing a significant shock and it has become a growing concern for researchers and policymakers who attempt to examine factors affecting the sustainability of the public health systems.  However, I think there is much that is under-specified in this paper. I have a few comments I would recommend the author/s will take care of. They are listed here, not according to their level of importance.

1.      Introduction:

The controversy over how to systematically measure the level of public health development is well introduced.

·               Some sentences repeat the same idea. Provide more concrete and precise examples. Please see the following sentence (that should be rewritten):

·               "Furthermore, the mismatch between public health care and socio-economic development is widespread in developing and even developed countries [24-26]. Studies have identified some of mismatches between the public health system and socio-economic development, for example…." ….. China, as the development country with the world's largest population and significant public health problems is an idea sample for discussing the relationship between the public health system and socio-economic development [34,35]."

·               Minor- the word pubulic in page 2.

·               Page 2: Please elaborate more clearly "Public health system is not isolated, it is embedded in socio-economic development."

·               What is your main theoretical contribution? Please stress what is your main motivation. The authors are required to introduce, succinctly, the theoretical framework/principles of this study.

·               Where similar previous studies have been done (outside China's public health)?

2.      Theory and Methodology

·         Page 2: Please re-edit the following sentence: "Researchers and found the impact of macro-factors, such as fanancial, institutions, and information, on the development of public health systems [41,42]." - and found, fanacial. 

·         Page 4: seven main. Typos that need to be corrected.

·         Details of the information/data collection process should be explain at the beginning of subsection no. 31. Also the origin of the data for each indicator (from the statistical yearbook).

·         Page 6: The China Health Statistical Yearbook (2012-2020) and official website of China’s Ministry of Health encompass the date needed for all the examined years?

3.      Discussion and Conclusions:

·         Beyond that this paper provides a quantitative study of public health systems and its coupling with socio-economic development, what the theoretical contribution is (a part that is also missing in the introduction and theoretical background parts). Please explain this point.

·         Do the findings support studies or previous findings/works?

·         In what way this paper contributes to the existing stream of study.

4.      Limitations:

·                 Are there more limitations of the methodology and the method of analysis that is important to note?

General comment:  Extensive editing of English language and style required. 

In sum, the subject under investigation is important, relevant and significant for sustainability studies. The paper has the potential for publication. Careful and rigorous work is required to present a better and more solid paper.  

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Reviewer 2 Report

Title:

The title of the manuscript should be improved. The adjectives are inappropriately placed.

Abstract:

1.       Usually abstract of a research article has a bit of the background of the study and a hypothesis statement. However, I cannot find any of such essential components of the abstract.

2.       Authors must revise the abstract to make it interesting for the reader.

3.       Choosing proper keywords helps web-based search engines feature an article. Authors should use subject-specific keywords rather than using very general and common keywords.

Introduction:

1.        The introduction contains numerous grammatical errors, spelling mistakes, and repetition of the words. The authors provide very general statements and do not mention the facts.

2.        In section 2, a theory, “Systematic Theory” has been introduced a theory. If authors suggest a new theory, they must discuss a little about the previous theories related to “Public Health” in the introduction section.

3.        In the second paragraph, the following sentence is ambiguous and requires the use of proper terminologies. Such as, the author mentioned “deaths”. What does it mean? Death rate or death ratio? Moreover, they used the term complex shock, which is also misleading and creates confusion.

“One traditional approach is to select one or several specific indicators as a proxy variable for public health, such as as daily cases, deaths, case fatality rate (CFR), intensive care unit (ICU) admissions and national measures taken for dissemination, etc. This

approach is indeed an easy one to use but hardly reflects the overall state of the public

health system. Some scholars suggest that facing the complex shock in the real world,

evaluating the effectiveness of public health system requires a more comprehensive

approach”

4.       In the fourth paragraph, the first sentence. Would authors like to elaborate on the phrase “mismatch between public health care and the socio-economic development”?

5.       The last paragraph of the introduction is unnecessary and should be omitted.

Theory and Methodology:

1.       The authors should make a table and compare the various studies related to public health system theories with their proposed theory. It will help the readers to get crisp information and the authors to decrease the length of the section. Authors can also draw a schematic diagram.

2.       Figure 1 must be replaced with a high-resolution figure.

3.       The last paragraph of page 4 has missing information about the symbols j.

Data:

1.       In section 3.2 author has not provided a reference for the statement, “ Ageing is one of the major social challenges in East Asia”.

2.       The authors claim in section 3.2 that there is no official data on the flow of labor in China. I can't entirely agree with this argument. International Monetary Fund’s (IMF) working paper " China’s Labor Market in the New Normal” provides the details of labor flow in China. Would the author like to comment on this? See the following weblink https://www.imf.org/external/pubs/ft/wp/2015/wp15151.pdf

3.        Figure 2 can be more comprehensive and valuable if authors change the unit from CYN to USD.

4.        Figure 3 needs an accurate description in the legend.

5.        Table 4 can be changed into a graph.

6.        Section 4.2’s statement that China’s health expenditure is lower than emerging market countries should be supported by a reference.

Conclusion:

1.       The conclusion is poorly written. Authors should revise it and also provide the implications of their study.

Comments for author File: Comments.pdf

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Page 2:

"In particular there is controversy over how to systematically measure the level of public health development. In particular, there is lacka lack of systematic quantitative research on public health systems in regional or national level [21,22]. In order to fill this research gap, we introduce the systematic theory to construct an evaluation method for the level of public health development." 

Edit the paragraph again and with one "in particular".  

Page 2:

"Although scholars have focused on the systematic, comprehensive approaches in evaluating public health systems [15-17],"

A sentence without an ending and incomplete explanation.

Page 2:

"As an example,Furthermore, the mismatch between public health care and socio-economic development is widespread in developing and even developed countries [264-286]."

Edit the paragraph. 

Page 3:

Researchers and found the impact of macro-factors, such as fanancial, institutions, and information, on the development of public health systems [41,42]

Edit the paragraph (maybe you intend to write - researchers have found)  

Author Response

Please see the attachment.

Author Response File: Author Response.docx

Reviewer 2 Report

The revised manuscript looks improved and well written. The authors revised the manuscript in the best possible manner. 

Author Response

Dear reviewer,

 We highly appreciate the helpful comments that the you have provided. 

 Best regards!