PONE-D-21-22117Socio-spatial disparities in access to emergency health care - a Scandinavian case studyPLOS ONE

Dear Dr. Hassler,

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 suggestions, I am recommending a major revision for this paper.  Looking forward to see a revised version. 

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Kind regards,

Srinivas Goli, Ph.D.

Academic Editor

PLOS ONE

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Additional Editor Comments:

Considering my own reading and reviewer suggestions, I am recommending a major revision for this paper. Looking forward to see a revised version.

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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

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

Reviewer #3: Yes

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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: No

Reviewer #2: Yes

Reviewer #3: Yes

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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: No

Reviewer #2: Yes

Reviewer #3: Yes

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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: Dear Respectable Authors

Thank you for considering a great area of research related to socio-capital disparities and its impact on access to emergency health care. Your manuscript is well-design but the structure if your manuscript needs revision. Please look at the similar article and re-structure your manuscript. I recommend some revision for better reporting the manuscript as follow;

- Abstract, please add statistical analysis in brief in this section.

- The whole structure of your manuscript is not good and for example, the introduction and the methods sections are a bit messy. Some information regarding method reported in the introduction. Please report the method based on the stages of the study. Also the results based on the study questions.

- Please separate reference, for example references 1-5. Also, in my opinion the number of references is high and some references not closely related to your topic. for example references 2 and 4.

- Please add the gap of evidence and also the novelty of your work in the introduction section.

- Provide a brief description of the emergency care system in the country in terms of statistics.

- In general, the article is very long. There is no need to review texts with this extent and it is better to summarize.

- lines 178-9, on what basis are these suggestions made?

- The quality of figures is low. Please remove Fig 1.

- In question 3, you stated some references. Explain the reason.

- In my opinion you have 5 questions not 3.

- The evidence related to "golden hour" is not enough at both national and international levels.

- SEK? please add full term for the first time.

- Please report demographic information regarding table one at the first paragraph of the results section.

- Please separate the conclusion and the recommendations. IN conclusion you needs briefly address the answer to the aim/question of the study regardless of statistical difficulties. Also, remove recommendation from conclusion and report it under separate subheading.

- what is your practical recommendation for health policymaker and government bodies to decrease the number of state with low access?

Cheers

Reviewer #2: The authors have done a great work, though it needs some corrections

Table 1. Descriptive data for the socioeconomic, demographic and area type variables separated by total, areas within and areas outside of the ‘golden hour'

Figures in the tables must be presented clearly, instead of median , better to present as number (%) for demographic & Socio-economic variables and Spatial variables

Grammatical errors should be rectified.

We appreciate the tools used in the manuscripts are acceptable and very well depicted.

Reviewer #3: The paper examines three variables presence of elderly, educational level and rural location. However, while it has provided multivariate analysis for first and third, it does not report the co-relation between elderly population and lower educational level. Expectedly, they would be co-related. In the review of literature, the authors do not elaborate on the reasons why these disparities would persist even in a highly developed and small country like Sweden. The authors also do draw any inferences from primary research on the human factors involved in the delay - are elderly anxious about hospitalisation? Do mobility issues affect their ability to alert neighbors, welfare staff who could call for the ambulance, in case they can not.

While it is acceptable that this paper only analyses data on infrastructure and broad demographic characteristics of the area, some effort is required to bring in more depth in the analysis and description by referring to other literature, which would help to complete the whole picture.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: Yes: Neha Madhiwalla

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Socio-spatial disparities in access to emergency health care - a Scandinavian case study

PONE-D-21-22117R1

Dear Dr. Hassler,

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.

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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 my own reading and reviewers suggestions, I am recommending this paper for publication in PLOS One.

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

Reviewer #3: All comments have been addressed

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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

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #3: I Don't Know

**********

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

Reviewer #3: 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

Reviewer #3: 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: Dear Respectable authors

Thank you for addressing comments. In my opinion, your manuscript is acceptable in this fashion.

Cheers

Reviewer #3: Within the constraints of the available data and their domain expertise, the paper makes a valuable contribution

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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: Morteza Arab-Zozani

Reviewer #3: Yes: Neha Harshendra Madhiwalla