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Peer-Review Record

Health Care, Medical Insurance, and Economic Destitution: A Dataset of 1042 Stories

Reviewer 1: Anonymous
Reviewer 2: Anonymous
Received: 1 April 2019 / Revised: 20 April 2019 / Accepted: 25 April 2019 / Published: 27 April 2019
(This article belongs to the Special Issue Big Data and Digital Health)

Round 1

Reviewer 1 Report

This is an interesting manuscript that can be improved if there was a key that defines how the coded names were measured. Some are self-explanatory such as SES and seriousness of injury, but other are not such as insL and burden. 

Author Response

Letter of detailed responses to Reviewer 1

Dear Sir/Madam,

Thank you very much for spending a great amount of time and effort you have put in to reviewing our manuscript. Your detailed comments have helped us improve the quality of our paper.

We have addressed your points in our revised version. Please notice that in the revised paper, the parts that are highlighted in yellow is for correction on the old text, the parts highlighted in green is written anew. Below are our answers to your comments (in italic). Also, the line numbers in the text refer to the revised paper.

This is an interesting manuscript that can be improved if there was a key that defines how the coded names were measured. Some are self-explanatory such as SES and seriousness of injury, but other are not such as insL and burden.

Thank you for your comments. We had examined the explanations of variables in two tables carefully and had made proper adjustments to better signify how some variables were measured:

Burden

Self-reported   evaluation of patient’s and family’s financial situation after paying   treatment fees: Minimally affected (A), Adversely affected (B), Destitute   (C), Adversely destitute (D).

IfHigher

Self-reported   evaluation of patient’s and family’s financial situation if patient continues   treatment. The values of this variable is the same as ‘Burden’.

InsL

Categories   of the amount that insurance covered. It is based on the numerical variable   ‘Pins’, which is the portion of fees covered by insurance reimbursement.

IncRank

Ranking of patient’s income.

Unit: Million of VND (Vietnam Dong)

AvgCost

Average cost that patient spent daily during the   treatment. Unit: Million of VND (Vietnam Dong)

SES

Socio-economics status of the patient. This variable   was based on IncRank (the   ranking of patient’s income) of the patient’s guardians if required.

 

We appreciate the hard work and time that you have spent on this manuscript. Your comments and suggestions have helped us improve the quality of our paper. We hope that the revised paper has met your requirements.

Please accept our sincere thanks for your great contributions to the improvement of higher studies on public health and the overall advancement of sciences in the world.

Shall you have further comments, we look forward to hearing from you.

Best regards,


Reviewer 2 Report

Health care, health insurance and economic destitution: A dataset of 1042 stories

This manuscript describes an interesting dataset derived from surveys conducted on 1042 in-patients in hospitals in the northern regions of Vietnam. It explores patients’ socioeconomic status, length of stay, seriousness of presenting illness, employment status, income, insurance level, burden of the cost of health care, completion of medical care, and additional informal costs (such as bribes or thanking a doctor). This dataset has the potential to better understand the impact of individual and system-level factors on a range of health outcomes.

Before considering this manuscript to be ready for publication I have some questions and suggestions for the authors in areas which require some revision:

1.     The lay out of the manuscript follows the journal policy but I think Table 1 and table 2 should be reported consecutively as the graphs that sit between them do not make sense without knowing the variables contained in Table 2. I think the authors should reconsider their order of reporting these items.

2.     Table 1 extends over 3 pages – the header row should be repeated for ease of reading ; same for Table 2

3.     Table 1 and 2 – describe what VND is – I assume this is Vietnamese dong, but not all readers will know this.

4.     Figures 1 & 2: The captions for the tables are not easily understood – can the authors provide captions that describe what they are portraying in these graphs.

5.     Table 2: What is the standard deviation around the mean for each variable?

6.     Line 81 – The sentence that begins with “The cost of doctor and drugs….” Could be better written, for example “The cost of visiting a doctor and drugs are relatively expensive for many households”

7.     Line 84: The first sentence could be written as “Low-income households usually spend  a higher percentage of their monthly income on health services than wealthier households. As a result, the risk of being destitute seems to be higher among poor households”

8.     Methods: I would suggest including a map of the hospital locations to provide some visual information in relation to the geographic distribution of the hospitals.

9.     Figure 4 and Figure 5: The captions are not clear; the x and y axes need labels and the legends need some explanation.

10.  Conclusion: the first sentence should start “This data descriptor article……”

11.  Line 144 – ‘on’ should be ‘from’; Line 145: ‘which’ should be inserted between ‘publications‘ and ‘contributed’.

12.  Line 152 – ‘area’ should be ‘areas’ and ‘context’ should be ‘contexts’

Overall some English language editing will be needed to make sure the manuscript flows and the authors’ explanations are clear and accurate.

 

Author Response

Letter of detailed responses to Reviewer 2

Dear Sir/Madam,

Thank you very much for spending a great amount of time and effort you have put in to reviewing our manuscript. Your detailed comments have helped us improve the quality of our paper.

We have addressed your points in our revised version. Please notice that in the revised paper, the parts that are highlighted in yellow is for correction on the old text, the parts highlighted in green is written anew. Below are our answers to your comments (in italic). Also, the line numbers in the text refer to the revised paper.

Data Description

1. The lay out of the manuscript follows the journal policy but I think Table 1 and table 2 should be reported consecutively as the graphs that sit between them do not make sense without knowing the variables contained in Table 2. I think the authors should reconsider their order of reporting these items.

Thank you very much for pointing this out. We have changed the order of Table 2 to before Figure 1 and 2 for more coherence.

2. Table 1 extends over 3 pages – the header row should be repeated for ease of reading; same for Table 2

Thank you very much for your suggestion. We have inserted the table headers at the beginning of every page for ease of reading.

3. Table 1 and 2 – describe what VND is – I assume this is Vietnamese dong, but not all readers will know this.

Thank you for reminding us. We have added explanation for “VND” in the table: Million of VND (Vietnamese Dong).

4. Figures 1 & 2: The captions for the tables are not easily understood – can the authors provide captions that describe what they are portraying in these graphs.

Thank you very much for your comment. We have rewritten captions of Figure 1 and 2 (line 68 and line 73 respectively).

“Figure 1. The level of ‘Income’, ‘Spent’, and ‘Dcost’ according to types of ‘Burden’ of the patient”

Figure 2. The level of ‘Income’, ‘Spent’, and ‘Dcost’ according to types of ‘IfHigher’ of the patient”

5. Table 2: What is the standard deviation around the mean for each variable?

We have included the standard deviation around the mean for each variable in Table 2.

6. Line 81 – The sentence that begins with “The cost of doctor and drugs….” Could be better written, for example “The cost of visiting a doctor and drugs are relatively expensive for many households”

Thank you very much for your recommendation. We have rewritten the sentence as follows (line 82 – 83):

“The cost of visiting a doctor and drugs are relatively expensive for many households”

 

7. Line 84: The first sentence could be written as “Low-income households usually spend a higher percentage of their monthly income on health services than wealthier households. As a result, the risk of being destitute seems to be higher among poor households”

Thank you for your suggestion. We have rewritten the sentence as you suggested as follows (line 85 – 88):

“Low-income households usually spend a higher percentage of their monthly income on health services than wealthier households. As a result, the risk of being destitute seems to be higher among poor households [8]. As a result, the risk of being destitute seems to be higher among poor households.”

8. Methods: I would suggest including a map of the hospital locations to provide some visual information in relation to the geographic distribution of the hospitals.

Thank you for your suggestion. However, we were unable to draw a comprehensive map of the hospital locations due to technical problems. We will prepare and include some visual information for the geographic distribution of the hospitals in future research articles.

Methods

9. Figure 4 and Figure 5: The captions are not clear; the x and y axes need labels and the legends need some explanation.

Thank you for noting this. We have reedited Figure 5 and 6 as well as rewritten the caption (line 136 – 139, and line 143 – 147).

Figure 4. Probabilities corresponding to the status of burden outcomes based on the conditions of residency and insurance. Recreated from the idea in [4]. Note: Minimally affected (A), Adversely affected (B), Destitute (C), Adversely destitute (D).”

Figure 5. Probabilities of destitution corresponding to both long-time and short-time hospitalization based on the conditions of residency and insurance. Recreated from the idea in [4]. Note: destitution with long-time hospitalization (DestLong) and destitution with short-time hospitalization (DestShort).”

 

10. Conclusion: the first sentence should start “This data descriptor article……”

Thank you for your suggestion. We have rewritten the sentence (line 149 and 150).

“This data descriptor article presents a comprehensive dataset on the situations and opinions of inpatients regarding the cost of treatment at hospital”.

 

11. Line 144 – ‘on’ should be ‘from’; Line 145: ‘which’ should be inserted between ‘publications‘ and ‘contributed’.

Thank you for pointing this out. We have fixed the grammatical errors according to your suggestion (line 150 – 153).

“Smaller subsets extracted from this dataset were the backbone of five different health economic publications, which contributed significantly to the literatures of healthcare, health insurance, patients’ satisfaction with the hospital, and their financial destitution.”

 

12. Line 152 – ‘area’ should be ‘areas’ and ‘context’ should be ‘contexts’

Thank you for reminding us. We have fixed the words you mentioned correctly (line 158 and 159).

“In different areas with different economic contexts, specific findings may not hold.”

English Editing

Overall some English language editing will be needed to make sure the manuscript flows and the authors’ explanations are clear and accurate.

Thank you for your useful comment. We have extensively edited the manuscript for its English to make sure no wording or grammatical error is left.

We appreciate the hard work and time that you have spent on this manuscript. Your comments and suggestions have helped us improve the quality of our paper. We hope that the revised paper has met your requirements.

Please accept our sincere thanks for your great contributions to the improvement of higher studies on public health and the overall advancement of sciences in the world.

Shall you have further comments, we look forward to hearing from you.

Best regards,

Round 2

Reviewer 2 Report

I thank the authors for their prompt responses. The authors have satisfactorily responded to all comments and I recommend that this manuscript is accepted. 

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