Examining area-level variation in service organisation and delivery across the breadth of primary healthcare. Usefulness of measures constructed from routine data

D. C. Butler; L. R. Jorm; S. Larkins; J. Humphreys; J. Desborough; K. J. Korda

doi:10.1371/journal.pone.0260615

Peer Review History

Original SubmissionMay 8, 2021
12 Oct 2021 Decision Letter - Srinivas Goli, Editor PONE-D-21-15234Examining area-level variation in service organisation and delivery across the breadth of primary healthcare. Usefulness of measures constructed from routine dataPLOS ONE Dear Dr. Butler, 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. ============================== ACADEMIC EDITOR: Considering my own reading and reviewer suggestion, I am recommending a minor revision for this manuscript. Please address the minor comments made by reviewer and submit the revision. ============================== Please submit your revised manuscript by Nov 26 2021 11:59PM. 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Thank you for stating the following in the Acknowledgments Section of your manuscript: “This research was supported through a grant from the Australian Government through the National Health and Medical Research Council Postgraduate Scholarship (GNT1038903).” We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “DB. This research was supported through a grant from the Australian Government through the National Health and Medical Research Council Postgraduate Scholarship (GNT1038903). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. 4. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. 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If your ethics statement is written in any section besides the Methods, please delete it from any other section. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. Additional Editor Comments (if provided): Considering my own reading and reviewer suggestion, I am recommending a minor revision for this manuscript. Please address the minor comments made by reviewer and submit the revision. [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: Yes ******** 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: -Under conclusion the authors may suggest a targeted policy recommendation based one the major cities and inner cities variations where there are gaps in service delivery. -Under the map output authors should provide corresponding key interpretation to colour labelling of “1 2 3 4” ****** 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:** Kofi Aduo-Adjei [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.] 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 PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0260615.r001
Revision 1
21 Oct 2021 Author Response 21st October 2021 Professor Tanya Doherty Guest Editor, PLOS One call for Papers Health Services Research Dear Professor Doherty, TITLE Examining area-level variation in service organisation and delivery across the breadth of primary healthcare. Usefulness of measures constructed from routine data We wish to thank you for the opportunity to resubmit a revised version of our paper publication as original research in PLOS One call for Papers Health Services Research having addressed the additional requirements outlined by the Editor and the reviewer. Please see our detailed numbered responses below. RESPONSE TO THE EDITOR. 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming RESPONSE: We have reviewed our manuscript in detail and can confirm that it meets PLOS ONE’s style requirement as outlined in the templates available at the links provided 2. Please amend your current ethics statement to address the following concerns: a) Did participants provide their written or verbal informed consent to participate in this study? b) If consent was verbal, please explain i) why written consent was not obtained, ii) how you documented participant consent, and iii) whether the ethics committees/IRB approved this consent procedure. RESPONSE: Thank you for bringing this to our attention. We request our ethics statement to be amended as follows: Approval for this project was obtained from the Australian National University Human Research Ethics Committee (protocol 2011/703) and the AIHW Ethics Committee (EC2010/2/23). As this was a secondary analysis of aggregated data, individual consent (verbal or written) was not required. 3. Thank you for stating the following in the Acknowledgments Section of your manuscript: “This research was supported through a grant from the Australian Government through the National Health and Medical Research Council Postgraduate Scholarship (GNT1038903).” RESPONSE: Thank you for bringing this to our attention. We have deleted the acknowledgement section from the manuscript. We note that you have provided funding information that is not currently declared in your Funding Statement. However, funding information should not appear in the Acknowledgments section or other areas of your manuscript. We will only publish funding information present in the Funding Statement section of the online submission form. Please remove any funding-related text from the manuscript and let us know how you would like to update your Funding Statement. Currently, your Funding Statement reads as follows: “DB. This research was supported through a grant from the Australian Government through the National Health and Medical Research Council Postgraduate Scholarship (GNT1038903). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.” Please include your amended statements within your cover letter; we will change the online submission form on your behalf. RESPONSE: Thank you for this clarification. Having deleted the funding statement from the acknowledgement section, we wish for funding statement to remain in its current form. 4. In your Data Availability statement, you have not specified where the minimal data set underlying the results described in your manuscript can be found. PLOS defines a study's minimal data set as the underlying data used to reach the conclusions drawn in the manuscript and any additional data required to replicate the reported study findings in their entirety. All PLOS journals require that the minimal data set be made fully available. For more information about our data policy, please see http://journals.plos.org/plosone/s/data-availability. RESPONSE: Thank you for bringing this to our attention and your clarification. We wish for our data availability statement to be amended as follows. ABS Census and PHIDU data are available for download at https://www.abs.gov.au/websitedbs/censushome.nsf/home/historicaldata2006 and https://phidu.torrens.edu.au/social-health-atlases respectively. Other data used in this study cannot be shared publicly because data are owned by a third party and authors do not have permission to share these data. Detailed information for accessing the data underlying the results presented in the study are available from: AIHW health workforce, https://www.aihw.gov.au/about-our-data/accessing-data-through-the-aihw/data-on-request; AMPCo Medical workforce, https://www.ampco.com.au/ampco-data-services/; HERO data, http://www.healthstats.nsw.gov.au; MBS claims, https://www.servicesaustralia.gov.au/organisations/about-us/reports-and-statistics/statistical-information-and-data#contacts; and ARIA + https://arts.adelaide.edu.au/hugo-centre/services/aria. 5. We note that you have included the phrase “data not shown” or “data not available” in your manuscript. Unfortunately, this does not meet our data sharing requirements. PLOS does not permit references to inaccessible data. We require that authors provide all relevant data within the paper, Supporting Information files, or in an acceptable, public repository. Please add a citation to support this phrase or upload the data that corresponds with these findings to a stable repository (such as Figshare or Dryad) and provide and URLs, DOIs, or accession numbers that may be used to access these data. Or, if the data are not a core part of the research being presented in your study, we ask that you remove the phrase that refers to these data RESPONSE: On review of the manuscript the only section where this phrase is used is as follows: “Data not available at SA3 level were re-assigned using relevant population weighted correspondences publicly available through the ABS (that is, from 2006 statistical geographies to 2011 statistical geographies).” (methods, second last paragraph) This is not referring to data or results being withheld, but rather indicating how we aggregated the data for analysis. As such we have not made changes to the manuscript in relation to this. 6. Your ethics statement should only appear in the Methods section of your manuscript. If your ethics statement is written in any section besides the Methods, please delete it from any other section. RESPONSE: We can confirm that our ethics statement appears only in the methods section of our manuscript. 7. Please review your reference list to ensure that it is complete and correct. If you have cited papers that have been retracted, please include the rationale for doing so in the manuscript text, or remove these references and replace them with relevant current references. Any changes to the reference list should be mentioned in the rebuttal letter that accompanies your revised manuscript. If you need to cite a retracted article, indicate the article’s retracted status in the References list and also include a citation and full reference for the retraction notice. RESPONSE: We have reviewed our reference list and can confirm it is complete and correct. RESPONSE TO THE REVIEWER. 1. Reviewer #1: -Under conclusion the authors may suggest a targeted policy recommendation based one the major cities and inner cities variations where there are gaps in service delivery. -Under the map output authors should provide corresponding key interpretation to colour labelling of “1 2 3 4” RESPONSE: We thank the reviewer for their comments. We have revised the conclusion in line with the reviewer’s suggestion to the following. Identifying avenues for PHC system reform requires appropriate empirical measurement of the organisation and delivery of services of areas. The extent and nature of how this varies may then provide insights as to best practice for achieving equitable and high-quality care. To that end, this study offers direction and clarification. Given the available data, the measures constructed represent the best approximation at a meaningful geographical scale from the domains of access, comprehensiveness and coordination relevant to policy and service planning. In terms of equity, initiatives should consider addressing the maldistribution of GPs by remoteness and area disadvantage. Initiatives should also consider increasing preventative care in disadvantaged areas across all regions and after-hours care in disadvantaged regional locations. With respect to the map output, the corresponding key interpretation to the colour labelling is provided in the figure legend. We defer to the editors preference as to whether this should be amended to be included in the image. We also wish to bring to the attention of the Editor that we have made some very minor edits for clarity of wording and to correct grammatical errors (see page 5, 17, 19). We thank the Editor and reviewer for their time and consideration of our manuscript. We very much hope you will find it suitable for publication in PLOS One-call for papers, Health Services Research. Yours sincerely, Dr Danielle Butler, corresponding author, on behalf of all authors https://doi.org/10.1371/journal.pone.0260615.r002
15 Nov 2021 Decision Letter - Srinivas Goli, Editor Examining area-level variation in service organisation and delivery across the breadth of primary healthcare. Usefulness of measures constructed from routine data PONE-D-21-15234R1 Dear Dr. Butler, 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, Srinivas Goli, Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Considering the reviewer suggestion and my own reading of this paper, I am recommending this paper for publication. 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? Reviewer #1: Yes ****** 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: Yes ****** 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: 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:** Kofi Aduo-Adjei https://doi.org/10.1371/journal.pone.0260615.r003
Formally Accepted
18 Nov 2021 Acceptance Letter - Srinivas Goli, Editor PONE-D-21-15234R1 Examining area-level variation in service organisation and delivery across the breadth of primary healthcare. Usefulness of measures constructed from routine data Dear Dr. Butler: 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. Srinivas Goli Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0260615.r004

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