The cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016

Minkyung Jo; Hyun-Jin Kim; Soo Jung Rim; Min Geu Lee; Chul Eung Kim; Subin Park

doi:10.1371/journal.pone.0235736

Peer Review History

Original SubmissionAugust 5, 2019
2 Oct 2019 Decision Letter - Rosa Maria Urbanos Garrido, Editor PONE-D-19-22006 The cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016 PLOS ONE Dear Dr Park, 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. Editor comments: Before submitting the manuscript to peer review, some changes are necessary. In particular: At the Introduction, please include a brief description of the South Korean health care system. Please, justify the classification of costs. Usually, non-healthcare direct costs include formal and informal care; why are they considered as indirect costs? Also, why community mental healthcare center costs are not considered health care costs? Please, provide further detail about how the results are obtained (not only about data sources, but about the procedure to arrive to final figures which are shown in the manuscript). For instance, according to reference [10], “Schizophrenia and other psychoses are associated with violence and violent offending, particularly homicide. However, most of the excess risk appears to be mediated by substance abuse comorbidity”. How do you estimate the incarceration costs due to schizophrenia? Do you assume that all the incarceration costs corresponding to schizophrenic inmates are part of non-healthcare direct costs of schizophrenia? This is only an example, more detail should be given for the rest of calculations. The approach used to estimate indirect costs is the human capital approach, not the prevalence approach. Please, revise the Abstract, the Introduction and the Discussion sections accordingly. We would appreciate receiving your revised manuscript by Nov 16 2019 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Rosa Maria Urbanos Garrido, PhD Academic Editor PLOS ONE Journal Requirements: When submitting your revision, we need you to address these additional requirements. 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.journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and http://www.journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf 2. 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.] 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.0235736.r001
Revision 1
10 Dec 2019 Author Response We provided a brief description of the South Korean healthcare system in the Introduction as follows: Korea provides universal healthcare through National Health Insurance (NHI) and Medical Aid program. The NHI covers about 97% of the population and the rest is covered by Medical Aid. Consequently, it is possible to construct a health insurance database that contains key data such as health records, prescriptions, etc. Moreover, the NHI Service (NHIS) provides these data to researchers for research purposes. (pg.4) We included cost classifications as follows: Direct costs are disease-related payments which are divided into two parts: direct healthcare costs and direct non-healthcare costs. Indirect costs account for resources that are lost owing to the disease. (pg. 4) Direct healthcare costs are defined as medical care costs, which include inpatient care costs, outpatient treatment costs, pharmacy costs, and non-covered care costs. (pg. 5) Direct non-healthcare costs are defined as costs that are associated with patient management, other than direct healthcare costs. (pg. 5) Patients do not receive a diagnosis or prescription at a community mental health center; rather, patients visit community mental healthcare centers for rehabilitation purposes. In addition, most community mental healthcare costs are covered by the government, not by the individual. Therefore, community mental healthcare center costs were considered as direct non-healthcare costs. (pg. 6) The community mental healthcare center costs, sanatoria costs, and psychiatric rehabilitation costs were estimated by the annual operating costs from each report (e.g., annual operating cost of community mental healthcare center by local mental health centers in 2007 * treated prevalence rate of schizophrenia in 2007). We estimated the transport cost by multiplying the total number of hospital visits by the mean return fare [17]. (pg. 6) For the exact equations for indirect costs, see Supporting information. (pg. 7 and pg. 26) The cost-of-illness trend was estimated from a societal perspective using a prevalence-based approach for direct costs and a human capital approach for indirect costs. (pg. 2) The prevalence approach was utilized for direct costs, and the human capital approach was used for indirect costs. (pg. 4) This study was based on a societal perspective and we employed a prevalence-based approach for direct costs and a human capital approach for indirect costs. (pg. 16) We revised the Abstract, Introduction, and the Discussion per your request. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0235736.r002
11 May 2020 Decision Letter - Wen-Jun Tu, Editor PONE-D-19-22006R1 The cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016 PLOS ONE Dear Dr Park, 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. ============================== We would appreciate receiving your revised manuscript by Jun 25 2020 11:59PM. When you are ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. To enhance the reproducibility of your results, we recommend that if applicable you deposit your laboratory protocols in protocols.io, where a protocol can be assigned its own identifier (DOI) such that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). This letter should be uploaded as separate file and labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. This file should be uploaded as separate file and labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. This file should be uploaded as separate file and labeled 'Manuscript'. Please note while forming your response, if your article is accepted, you may have the opportunity to make the peer review history publicly available. The record will include editor decision letters (with reviews) and your responses to reviewer comments. If eligible, we will contact you to opt in or out. We look forward to receiving your revised manuscript. Kind regards, Wen-Jun Tu Academic Editor PLOS ONE Journal Requirements: 1. Please ensure that all statement are supported by adequate references, and that the references studies are critically analysed. For example, we note that your statement "Patients with schizophrenia are involved in crime more so than is the general population" does not seem to reflect the conclusions drawn by the study referenced ( Fazel, Seena, et al. "Schizophrenia and violence: systematic review and meta-analysis." PLoS medicine 6.8) , which concluded that "most of the excess risk appears to be mediated by substance abuse comorbidity". Please ensure that the aspect of substance abuse comorbidity is mentioned, to provide a balanced view on the association between schizophrenia and crime prevalence, and to reflect the content of the cited study. Additional Editor Comments (if provided): [Note: HTML markup is below. Please do not edit.] 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: All comments have been addressed ******** 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: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? 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Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 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: Silvia Coretti [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.0235736.r003
Revision 2
17 Jun 2020 Author Response We greatly appreciate the academic editor and reviewer for thoroughly reviewing our manuscript. We made revisions per the comments and suggestions that were provided, which are highlighted below. We hope our responses are suitable and that the revised manuscript is now acceptable for publication in PLoS One. Journal Requirements 1. Please ensure that all statement are supported by adequate references, and that the references studies are critically analysed. For example, we note that your statement "Patients with schizophrenia are involved in crime more so than is the general population" does not seem to reflect the conclusions drawn by the study referenced ( Fazel, Seena, et al. "Schizophrenia and violence: systematic review and meta-analysis." PLoS medicine 6.8) , which concluded that "most of the excess risk appears to be mediated by substance abuse comorbidity". Please ensure that the aspect of substance abuse comorbidity is mentioned, to provide a balanced view on the association between schizophrenia and crime prevalence, and to reflect the content of the cited study. � Thank you for providing this important comment. We clarified the association between schizophrenia and violence in the revised manuscript as follows: - Patients with schizophrenia are involved in crime (mediated by substance use comorbidity) more so than is the general population [9]. (pg. 5, lines 114–116) - Incarceration accounts for about 1% of the direct non-healthcare costs. However, considering the severity of the matter, efforts to prevent violence that is associated with schizophrenia are needed. A meta-analysis [9] that investigated the association between schizophrenia and violence stated that substance abuse comorbidity mediates the association between schizophrenia and violence. Therefore, experts need to consider preventing substance abuse among patients with schizophrenia. (pg. 15, lines 278–284) 2. 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. � We went through recent materials related to our topic in PLoS One and added one relevant study to our reference list, which revealed that patients with schizophrenia have a high risk of acquiring physical diseases (e.g., cardiovascular disease): - [10] Cunningham R, Poppe K, Peterson D, Every-Palmer S, Soosay I, Jackson R. Prediction of cardiovascular disease risk among people with severe mental illness: a cohort study. PLoS One. 2019;14(9): e0221521. Attachments Attachment Submitted filename: renamed_c6dee.docx https://doi.org/10.1371/journal.pone.0235736.r004
23 Jun 2020 Decision Letter - Wen-Jun Tu, Editor The cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016 PONE-D-19-22006R2 Dear Dr. Park, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. 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 help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- 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. Kind regards, Wen-Jun Tu Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: https://doi.org/10.1371/journal.pone.0235736.r005
Formally Accepted
1 Jul 2020 Acceptance Letter - Wen-Jun Tu, Editor PONE-D-19-22006R2 The cost-of-illness trend of schizophrenia in South Korea from 2006 to 2016 Dear Dr. Park: I'm 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 let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, 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. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. 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.0235736.r006

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