The Image of Healthcare Institutions in the Opinion of Patients—Evaluation of Factors Influencing the Assessment of Public Hospitals
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsIntroduction and Discussion
Hospital image build from several factors as the authors stated on page 2 lines 73-76 (Górska-Warsewicz, 2022). Why do the authors choose the patients perceive among other factors? How does the author differentiate between patient experience and patient satisfaction (Guan, 2024)?
References:
Górska-Warsewicz H. Consumer or Patient Determinants of Hospital Brand Equity-A Systematic Literature Review. Int J Environ Res Public Health. 2022 Jul 25;19(15):9026. doi: 10.3390/ijerph19159026. PMID: 35897398; PMCID: PMC9331757.
Guan, T., Chen, X., Li, J. et al. Factors influencing patient experience in hospital wards: a systematic review. BMC Nurs 23, 527 (2024). https://doi.org/10.1186/s12912-024-02054-0
Methods
How did the author develop questionnaires and what is the questionnaire validity and reliability results? The is a discrepancy between ‘the aim of the study’ and 'questionnaire item questions’. Is the questionnaire delivered face to face? What is the questionnaire response rate?
Page 2, lines 82-83: The aim of this study is to analyze the impact of selected factors—patients' sociodemographic characteristics, their personal experiences and the communication strategy used by public hospitals
Do the authors want to evaluate healthcare systems or healthcare services? How does the patient understand about the healthcare system (page 6: self-survey question)? How the author anticipates a normative answer when the patient answers a sensitive issue, such as ‘Corruption scandals’ (Rosenfeld, 2015)?
Reference:
Rosenfeld. American Journal of Political Science, Vol. 00, No. 0, xxxx 2015, Pp. 1–20. Available from: https://imai.fas.harvard.edu/research/files/validate.pdf
Results
There are typo errors in Table 1.
Comments on the Quality of English Languagemoderate
Author Response
Dear Reviewer,
thank you for your comment.
Please see the the attachment.
Authors
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThank you for your manuscript, please address the below points:
- In the introduction section, it is not clear if any similar research has been done in Poland. There are several studies referenced, but are all international - and as such it remains unclear if this subject has been tackled in Poland partially or not at all.
- In the methodology section, how was the questionnaire validated? Was it based on prior published questionnaires?
- Are there any questions that are specific to the local context, given that the questionnaire was distributed within a distinct geographical location?
- Were there any patients refusing to complete the questionnaire?
- Were there any particular exclusions for specific patient groups?
- What was the time window for the conduct of the study? Please provide exact dates if available.
- The limitations section should expand slightly on the self-reported bias
Author Response
Dear Reviewer,
thank you for your comment.
Please see the the attachment.
Authors
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsI am grateful for the opportunity to review this paper. I would like to leave some comments.
ABSTRACT
Lines 17 -18: “A cross-sectional survey was conducted 17 among 778 patients hospitalized in eight public hospitals in Wrocław.” Please “778” is a result
MATERIALS AND METHODS
-Line 86: “The study was conducted among 778 patients from eight public hospitals…” Please “778” is a result.
-Lines 89-90: “The aim of this study was to understand patients' opinions on the image of 89 medical facilities and to identify factors that influence their perceptions of hospitals.” This is a repetitive text.
-Lines 90-93: “The 90 study involved 445 women (57.2%) and 333 men (42.8%) aged 15-90 years (M = 53.2; SD = 91 17.2). Purposive random sampling was used, covering patients hospitalized in selected 92 specialist wards. The characteristics of the study group are presented in Table 1.” This information could be moved to “Results” section.
-The questionnaire could be available as Appendix.
-Lines 99-101: “Both closed (scaled) and open-ended questions allowed for quantitative and qualitative analysis of the data.” What about the analysis of the qualitative data? How did the authors conduct this analysis? Please clarify this information in the text.
RESULTS
-Please describe the characteristics of the Hospitals (Only for elderly people? Only for traumatic events? …)
-Lines 203-205: “The image of a healthcare provider is a combination of expectations based on repayment, media reports, or previous personal experiences and the degree of satisfaction with the healthcare services received and the stay at the facility.” This is not a result of the current study. Please move it to discussion section.
-I did not find the qualitative results of the study. Please include them in the Results section and discuss them in Discussion section.
DISCUSSION
-The authors could include recommendations in the text.
-The limitations could be moved to the end of this section.
Author Response
Dear Reviewer,
thank you for your comment.
Please see the the attachment.
Authors
Author Response File: Author Response.pdf
Reviewer 4 Report
Comments and Suggestions for Authors1)Line 3: “analysis of factors” could be more appropriate as “evaluation of factors”.
2)Line 12: “The perception of hospital image is increasingly important amid dynamic changes in health care systems and growing patient awareness. As patients become active participants in treatment, their opinions not only reflect satisfaction but also affect institutional reputation and competitiveness. This study examined how sociodemographic factors, prior experiences, and hospitals’ communication shape the perceived image of public hospitals in Poland. A cross-sectional survey was conducted among 778 patients hospitalized in eight public hospitals in Wrocław.”
The above part could be restructured for clarity. For example:
“Patients are increasingly aware of ways to manage their own health—especially regarding chronic diseases—along with the fundamental factors that should be present in well-organized and patient-oriented healthcare organizations. Due to the fact that the image of healthcare organizations depends on patients’ opinions, healthcare organizations are continuously improving and transforming their processes to increase patient satisfaction. This study aimed to analyze the relationship between patients’ opinions about the public hospitals in which they were treated and their level of satisfaction in Wrocław, Poland. A cross-sectional survey was conducted among 778 patients hospitalized in eight public hospitals.”
3)For conciseness,
Line 20: “expectations and satisfaction” could be “satisfaction”.
Line 97: “Expectations and satisfaction,” could be “Satisfaction,”.
4)The “Introduction” could be divided into several paragraphs. The following sentences could be the opening sentences of those paragraphs:
- Line 48: “In the literature on the subject, the image of a hospital is defined as a set of beliefs, feelings and impressions that a patient associates with a specific facility .....”
- Line 58: “International studies indicate that a positive image of a hospital can act as an intermediary between service quality and patient loyalty, strengthening patient satisfaction and willingness to use the facility's services again”
- Line 73: “Previous studies indicate that the perception of the image of healthcare institutions is shaped by many factors, the key ones being the quality of interpersonal communication, the availability of healthcare services, the conditions of the premises and the overall organization of treatment”
5)There are inconsistencies in the citation style within the text, such as “[5] [6]” and “[7,8]”.
6)Line 81: “The aim of this study is to analyze the impact of selected factors—patients' sociodemographic characteristics, their personal experiences and the communication strategy used by public hospitals - on how patients perceive the image of these facilities”
The above sentence could be restructured for clarity. For example:
“The aim of this study was to analyze the relationship between patients’ opinions—the basis for the perceived image of healthcare organizations—and patient satisfaction in Wrocław, Poland.”
7)There are typographical errors in Table 1:
“Provinxce” could be “Province”.
“Lover Silesia” could be “Lower Silesia”.
“stay::” could be “stay:”.
“beed” could be “been”.
“Bo information” could be “No information”.
8)The titles of Tables 2 and 3 are identical. In the title of Table 3, “health care system” could be “relevant hospital” etc.
9)There are duplicate captions in the figures. The captions integrated within the figures should be removed, and only the captions in the main text should be retained.
10)Line 116: “In addition, an analysis was conducted on factors important to patients who influence their satisfaction with their hospital stay and their willingness to recommend the facility to others. Particular attention was also given to the role of communication with staff and the perception of health promotion activities in the hospitals surveyed. These data form the basis for further analysis of the relationship between the subjective perceptions of healthcare institutions and their social image.”
The above paragraph in “Materials and Methods” could be removed for conciseness.
11)Line 123: “The study included 778 patients hospitalized in eight public hospitals in Wrocław.”
The above sentence in “Results” could be removed for conciseness.
12)Line 205: “Patients were first asked to rate their expectations of the hospital on a scale of 1-5 before starting treatment there and then to rate their satisfaction with their stay.”
The above sentence could be restructured for clarity and conciseness. For example:
“Patients were asked to rate their satisfaction and expectations regarding the hospital on a scale of 1-5.”
13)Line 220: “This means that patients who declared higher expectations were more likely to rate their stay as satisfactory.”
The above sentence could be removed for conciseness.
14)The “Discussion” could be divided into several paragraphs. The following sentences could be the opening sentences of those paragraphs:
- Line 234: “The results confirm the concept previously postulated in the literature .....”
- Line 254: “In the context of sources of information about medical facilities .....”
- Line 259: “Comparable findings come from studies conducted in Central and Eastern European countries .....”
15)Line 256: The role of the media was marginal (approx. 5.7%).”
The above sentence could be removed for conciseness.
16)Line 277: “The results confirm that the image of a hospital in the eyes of patients is a complex construct .....”
“The results confirm that” could be clearer as “According to the results of the study”.
“is a complex” could be clearer as “is indeed a complex”.
17)Line 308: “Future studies should expand to more diverse populations, employ validated measurement tools, and consider longitudinal or mixed-methods approaches.”
“tools” could be clearer as “instruments”.
“approaches” could be clearer as “designs”.
18)The 2nd and 3rd paragraphs of the “Conclusions” could be removed for conciseness.
19)“Limitations of the study” could be moved to “Discussion”.
Decision: Minor Revision
Author Response
Dear Reviewer,
thank you for your comment.
Please see the the attachment.
Authors
Author Response File: Author Response.pdf
Round 2
Reviewer 3 Report
Comments and Suggestions for Authors Congratulations on the text. I only have four comments. OBJECTIVES Lines 17-18: “This study aimed to analyze the relationship between patients’ opinions about the public 17 hospitals in which they were treated and their level of satisfaction in Poland” / Lines 91-94: “The aim of this study was to evaluate how selected factors, including patients’ socio-demographic characteristics, previous hospital experiences, sources of information, and satisfaction with hospitalization, are associated with the patient-perceived image of public hospitals in Poland.” Please align the objectives. ABSTRACT -Lines 19 -20: “The study included 778 hospitalized patients.” Please “778” is a result. -Line 18: Please remove “spitals.” MATERIALS AND METHODS Lines 108-109: “The final study sample included 778 hospitalized patients.” Please “778” is a result. TEXT Line 370. The authors could separate the item 5.Conclusions from Discussion section.Author Response
Dear Reviewer
Thank you for these valuable comments and suggestions, which helped us improve and enrich the manuscript. The revised version of the manuscript has been uploaded.
- Abstract
The sentence “The study included 778 hospitalized patients” was removed from the Abstract, as the final sample size constitutes a study result and is now reported only in the Results section. - Abstract
The typographical error (“spitals.”) was corrected in the revised manuscript. - Materials and Methods
The sentence “The final study sample included 778 hospitalized patients” was revised to avoid presenting the final sample size in the Methods section. The final number of participants is now reported only in the Results section. - Text
The “Conclusions” section was separated from the Discussion section and formatted as an independent section in the revised manuscript.
Kind regards,
Authors
