Comparison of patient perceptions of primary care quality across healthcare facilities in Korea: A cross-sectional study

Yongjung Cho; Heeyoung Chung; Hyundeok Joo; Hyung Jun Park; Hee-Kyung Joh; Ji Won Kim; Jong-Koo Lee

doi:10.1371/journal.pone.0230034

Peer Review History

Original SubmissionNovember 8, 2019
23 Dec 2019 Decision Letter - Wen-Jun Tu, Editor PONE-D-19-31223 Comparison of patient perceptions of primary care quality across healthcare facilities in Korea: a cross-sectional study PLOS ONE Dear Dr Joh, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. In order to provide a more complete information to our readers on the topic, we would like to emphasize the importance to cross referencing very recent material on the same topic published in "PLoS ONE ". Therefore, it would be highly appreciated if you would check the contents published in the last two years of "PLoS ONE" (https://journals.plos.org/plosone/) and add all material relevant to your article to the reference list. 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We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. In your revised cover letter, please address the following prompts: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. Please see http://www.bmj.com/content/340/bmj.c181.long for guidelines on how to de-identify and prepare clinical data for publication. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. We will update your Data Availability statement on your behalf to reflect the information you provide. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The manuscript is of great relevance to public health. But I believe the discussion could be more robust, given the data presented. In the discussion the main results are presented unnecessarily as they are all available in the "results" field. A large number of articles used in the discussion have more than 10 years of publication (33.0%). The inclusion of more current articles is necessary. I suggest discussing about the final sample size, 16.9% of the sample recruited. In addition to this issue, the sample was restricted to university users. Could these questions have influenced the results? Was the final sample size representative? The fact that they are all from university may have influenced the positive result for the service offered in this establishment? Can these questions be a limitation of the study? I also suggest reviewing the formatting of the text and reviewing the writing of very long paragraphs. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Fernanda Piana Santos Lima de Oliveira [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files to be viewed.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email us at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0230034.r001
Revision 1
6 Feb 2020 Author Response Dear Editor, We deeply appreciate the opportunity to revise and re-submit our manuscript, titled “Comparison of patient perceptions of primary care quality across healthcare facilities in Korea: a cross-sectional study” to PLOS ONE. The reviewers' comments and suggestions were highly valuable in improving the quality of our manuscript. Below, we have addressed the editor’s and reviewers’ concerns in a point-by-point manner. We hope that the revised manuscript meets with your approval for publication. Again, thank you very much for your thorough review of our manuscript. Sincerely, Hee-Kyung Joh -------------------------------------------------------------- Responses to academic editor: 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at http://www.plosone.org/attachments/PLOSOne_formatting_sample_main_body.pdf and http://www.plosone.org/attachments/PLOSOne_formatting_sample_title_authors_affiliations.pdf --> Per the editor’s comment, we have modified our manuscript and file names to meet the PLOS ONE’s style requirements. 2. Please include additional information regarding the survey or questionnaire used in the study and ensure that you have provided sufficient details that others could replicate the analyses. For instance, if you developed a questionnaire as part of this study and it is not under a copyright more restrictive than CC-BY, please include a copy, in both the original language and English, as Supporting Information. --> Per the editor’s comment, we have included a copy of the questionnaire that we used in our study as Supporting Information (S1 and S2 Files) in both the original language and English. 3. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. --> Per the editor’s comment, we have included captions for the Supporting Information files at the end of our manuscript (page 27), and updated in-text citations to match accordingly (page 8, line 103; page 13, line 193). 4. We note that you have indicated that data from this study are available upon request. PLOS only allows data to be available upon request if there are legal or ethical restrictions on sharing data publicly. For information on unacceptable data access restrictions, please see http://journals.plos.org/plosone/s/data-availability#loc-unacceptable-data-access-restrictions. In your revised cover letter, please address the following prompts: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially identifying or sensitive patient information) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. Please see http://www.bmj.com/content/340/bmj.c181.long for guidelines on how to de-identify and prepare clinical data for publication. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. We will update your Data Availability statement on your behalf to reflect the information you provide. --> We acknowledge that there are no restrictions on sharing the de-identified data set that we have uploaded as a Supporting Information file (S1 Data). We have indicated this information in the revised cover letter. Responses to Reviewer #1 1. The manuscript is of great relevance to public health. But I believe the discussion could be more robust, given the data presented. --> We appreciate the reviewer’s comment. Per the reviewer’s suggestion, we have revised our Discussion section to make it more solid and based on our study results. We also have reorganized the paragraphs and have added more discussions on outpatient hospital care. The following paragraphs are one example: “Globally, the importance of providing healthcare at the right time and place, without compromising on care quality, is being emphasized.[3] Unnecessary utilization of hospital outpatient care is one of the main contributors of escalating healthcare costs.[25] Substituting hospital outpatient care with primary care is recommended as a solution to accomplish efficient and cost-effective healthcare delivery.[1,3] Evidence supports this perspective, indicating shorter waiting lists, shorter clinic waiting times, and higher patient satisfaction after the substitution interventions.[25] Nonetheless, we found that the levels of trust and user satisfaction were highest for hospitals. This user view might be partly linked to the belief that good facilities and equipment of large hospitals guarantee good qualities of care.[13,23] Similar user misperception and distorted health-seeking behaviors were also reported in China; community individuals preferred to seek care in second or tertiary hospitals rather than primary care facilities, although the latter provide more accessible and affordable care. An important driver for this health-seeking behavior was trust in doctors in tertiary hospitals.[13] Therefore, efforts to raise public trust in primary care physicians and facilities are essential.” (Manuscript file, page 19–20, line 292–306) Please refer to the ‘Manuscript’ file (page 16–21) and ‘Revised Manuscript with Track Changes’ file (page 16–22) to check the entire revision of the Discussion section. We have highlighted in yellow for the newly added parts in the Revised Manuscript with Track Changes file. 2. In the discussion the main results are presented unnecessarily as they are all available in the "results" field. --> Per the reviewer’s comment, we have summarized the main results as concise as possible in the revised version. In addition, we have moved the following sentences to the Method section: “A university health service is a primary care model on campus dealing with medical care and health promotion of university students and employees. The university health service in this university implements a wide range of activities: primary medical consultation for acute and chronic diseases, mental health care, communicable disease prevention, immunizations, health screening, and health education. Family physicians play the central role in these activities, partly supported by some specialty care.”(Manuscript file, page 7, line 94–99) 3. A large number of articles used in the discussion have more than 10 years of publication (33.0%). The inclusion of more current articles is necessary. --> Per the reviewer’s comment, we have additionally reviewed more recent studies and articles. In the revised version, 16 papers have been newly added, and 13 of them were published within 10 years. Overall, 28 of 40 (70%) references were published within 10 years, and 11 references within 2 years. 4. I suggest discussing about the final sample size, 16.9% of the sample recruited. In addition to this issue, the sample was restricted to university users. Could these questions have influenced the results? Was the final sample size representative? The fact that they are all from university may have influenced the positive result for the service offered in this establishment? Can these questions be a limitation of the study? --> We agree with the reviewer’s point. Per the reviewer’s suggestion, we have added this point in the limitations as follows: “Fourth, we cannot rule out sampling bias. Because our sample was recruited from a university, this might have influenced the positive results for the university service. Although we did not restrict our sample to the users of the university health service to decrease such bias, our sample size (16.9% of the study population) and the non-random sampling method could have limited its representativeness.” (Manuscript file, page 21, line 323–327) 5. I also suggest reviewing the formatting of the text and reviewing the writing of very long paragraphs. --> We appreciate the reviewer’s comment. Per the reviewer’s suggestion, the Discussion section was re-formatted. We have re-organized paragraphs to be shorter, using several subtitles, to enhance readers’ readability. Also, long sentences were trimmed as concisely as possible. Please refer to the ‘Manuscript’ file (page 16–21) and ‘Revised Manuscript with Track Changes’ file (page 16–22) to check the entire revision of the Discussion section. Attachments Attachment Submitted filename: Response to Reviewers.HKJOH.20200205.docx https://doi.org/10.1371/journal.pone.0230034.r002
20 Feb 2020 Decision Letter - Wen-Jun Tu, Editor Comparison of patient perceptions of primary care quality across healthcare facilities in Korea: a cross-sectional study PONE-D-19-31223R1 Dear Dr. Joh, We are pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it complies with all outstanding technical requirements. Within one week, you will receive an e-mail containing information on the amendments required prior to publication. When all required modifications have been addressed, you will receive a formal acceptance letter and your manuscript will proceed to our production department and be scheduled for publication. Shortly after the formal acceptance letter is sent, an invoice for payment will follow. To ensure an efficient production and billing process, please log into Editorial Manager at https://www.editorialmanager.com/pone/, click the "Update My Information" link at the top of the page, and update your user information. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, you must inform our press team as soon as possible and no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. With kind regards, Wen-Jun Tu Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: (No Response) ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: (No Response) ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: (No Response) ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: (No Response) ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: (No Response) ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Fernanda Piana Santos Lima de Oliveira https://doi.org/10.1371/journal.pone.0230034.r003
Formally Accepted
24 Feb 2020 Acceptance Letter - Wen-Jun Tu, Editor PONE-D-19-31223R1 Comparison of patient perceptions of primary care quality across healthcare facilities in Korea: a cross-sectional study Dear Dr. Joh: I am pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please notify them about your upcoming paper at this point, to enable them to help maximize its impact. If they will be preparing press materials for this manuscript, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. For any other questions or concerns, please email plosone@plos.org. Thank you for submitting your work to PLOS ONE. With kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Wen-Jun Tu Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0230034.r004

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