PONE-D-24-34363Analysis of the utilization of traditional medicine in Korea over 10 years (2013-2022): A repeated cross-sectional study using national health insurance dataPLOS ONE

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“This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: RS-2024-00441486). This study utilized medical statistical information from 2013 to 2022 provided by the Health Insurance Review & Assessment Service (HIRA) Big Data Open Portal (opendata.hira.or.kr) in the Republic of Korea. ”

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“This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: RS-2024-00441486).”

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“This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: RS-2024-00441486).”

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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: Yes

Reviewer #2: Yes

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

Reviewer #1: Yes

Reviewer #2: 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: Yes

Reviewer #2: 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: Yes

Reviewer #2: 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: Expand the global relevance of TKM by referencing WHO policies or comparisons with other countries using traditional medicine systems.

The manuscript does not explain potential biases in claims data.

The description of statistical methods, such as CAGR calculation, is brief and lacks details on significance testing.

The repeated cross-sectional design limitations (e.g., inability to track individuals) are not adequately discussed.

The results acknowledge a decline during COVID-19 but do not provide sufficient detail.

Minimal discussion of how trends in Korea compare to other countries with traditional medicine systems.

Herbal drugs, an essential component of TKM, are excluded but this limitation is underemphasized.

Supporting data tables (S1–S6) are referenced but not adequately summarized in the main text.

Reviewer #2: The title

• It is clear, informative, and representative of the content and breadth of the study

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• It is complete and essential details are presented

The introduction/background

• It gives exhaustive literature information and describes the knowledge gap but lacks a research question for the intended study.

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• It is sufficiently described and sufficiently detailed to permit the study to be replicated.

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The conclusions and recommendations

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Recommendation as reviewer

• The manuscript adheres to the journal guidelines and standards.

• I fully agree with the acceptance of the manuscript after making minor revisions, particularly the necessary editorials.

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Reviewer #1: No

Reviewer #2: No

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Analysis of the utilization of traditional medicine in Korea over 10 years (2013-2022): A repeated cross-sectional study using national health insurance data

PONE-D-24-34363R1

Dear Dr. Shin,

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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Kind regards,

Marcelo Dionisio

Support Staff - Editorial

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 #3: All comments have been addressed

Reviewer #4: 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 #3: Yes

Reviewer #4: Yes

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

Reviewer #3: Yes

Reviewer #4: Yes

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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 #3: Yes

Reviewer #4: Yes

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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 #3: Yes

Reviewer #4: Yes

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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 #3: Thank you for your valuable article. It is valuable to examine the status of traditional medicine in order to analyze its benefits and disadvantages.

Reviewer #4: I am pleased to recommend the acceptance of this manuscript for publication in your esteemed journal. The study provides a comprehensive analysis of the trends and changes in the utilization of Traditional Korean Medicine (TKM) from 2013 to 2022, offering valuable insights into the structural and functional transformations within TKM.

The key findings, including the significant increase in inpatient services of TKM hospitals and medical expenses, as well as the diversification of diagnostic and treatment methods, highlight the evolving nature of TKM. These observations are crucial for understanding the current landscape of TKM and its integration into the broader healthcare system.

While the study acknowledges some limitations, its contributions to the field are substantial. The call for future research to include all TKM-related data and to examine sociocultural and clinical factors influencing TKM utilization is well-justified. Such comprehensive studies are essential for policymakers, healthcare providers, and researchers aiming to promote the effective integration of TKM and improve public health outcomes in Korea.

Overall, the manuscript is well-structured, and the conclusions are supported by the data presented. I believe that this study will contribute significantly to the ongoing discussions about the role of traditional medicine in modern healthcare systems.

Thank you for the opportunity to review this manuscript.

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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 #3: No

Reviewer #4: No

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