Psychological Profile and Consumption of Healthcare Resources in Actively Employed People, Pre-Retirees, and Retirees

Round 1

Reviewer 1 Report

Authors tried to address important issues related to the healthcare use of adults, including older adults with regard to their professional status - active workers, pre-retires, retires. They use quite big scope of methods that aloows to expect interesting and new results. Still some issues make the paper hardly readable:

1. In the rows 31-39 authors try to describe the situation with aging in the "society". But aging is quite dependant on the exact society, its socio-economic status, retirement legislation, values and attitudes to older adults in the society. Authors base their generalizations on some US and some Spanish studies, thus this generalization describe no real situation on aging. I would suggest that they would describe the situation in Spain since it would be much more relevant and coherent for the present study and paper.
2. In line 60 authors say that "Schoormans et al.  pointed out that, in some cases, the use of healthcare is not 60 only determined by the complexity of the health process or by the patient’s functional 61 status, but also by the patient’s psychological characteristics" , but it would be important to mention that yet in 1980-s Rowe and Kahn pointed out that one's health status is related to one's psychological characteristics.
3. The most important problem with the paper right now, from my perspective, is the way authors describe the sample. Generally, they don't describe the sample. They just point that participants were 51-69, and there were plenty of them. Still, there is description how authors splited the sample. It is clear how they identified retires (though there is no description of participants in this group, their age, sex, education, health status, etc). But when it comes to active workers and pre-retires it is absolutely unclear how they were identified and again - all the characteristics of the sample. From the perspective that the sample starts at 51, all of them can be called "pre-retires" to some extent. If there is some official status olders adults in Spain have that specific Agency can provide for research purposes, it is important to describe criteria for this status, since in different countries these groups can be defines in difference wyas. Without this information all the interpretations doesn't seem solid enough.

Author Response

See attached file

Author Response File: Author Response.pdf

Reviewer 2 Report

Thank you for providing opportunity of reviewing this manuscript. 

In current work the authors discussed Psychological profile and consumption of healthcare resources in actively employed people, pre-retirees, and retirees. 

The goal of the research is very interesting, but the way of analyzing currently looks like not adequate for this sort of journal. 

The next survey tools were used in this research:

1. The Time Paradox Inventory (ZTPI) (Actually, I could not find "Paradox" word in the naming of this survey in other works)
2. The Multidimensional Locus of Control Scale (Internality – Externality, I-E)
3. The scale of Psychological Reactance (PR)   
4. The Coping Responses Inventory (CRI)   
5. A scale of Self-Efficacy applied to Health (SEH),
6. Coping Responses Inventory (CRI)  

Majority of these surveys are based on multiple questions, which need different type of analysis. 

Authors of this work put all data of surveys in one table without any explanation of that reason and without trying to justify this sort of simplification. 

By doing so, it is not possible to judge about reliability of data. 

Another important point.
Authors did not provide explanation about pre-retirement age or period. For each country it is different. Is it only one year before retirement or it is 5-years period? There is also no explanation, why the number of this age group is so small comparing to other two.  

There are also possibilities of multiple confounders which are not discussed at all. 

 

Author Response

See attached file

Author Response File: Author Response.pdf

Reviewer 3 Report

I present my comments in the attached file.

 

 

Comments for author File: Comments.pdf

Author Response

Please see the attached document.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

Thatnk you for your clarifications. Still I have some concerns about the identification of active workers and pre-retires. At the moment it looks like people of the same age (55-65) can fall into different retirement categories. I understood that the Agency gives their status, but how the Agency identificates them? Is it based on their self-reports, or on the retirement strategy of the company they work in? I think it would be nice if you could add definition of active workers and pre-retires. Or maybe some timeline. Like active workers - those, who will retire in more than 10 years, pre-retires - less then 5 years or something like that.

Author Response

Dear reviewer:

Thank you very much for pointing out the error. Indeed, although on page 3 (lines 12 onwards) the following is correctly stated: “This research is of great relevance in Spain, where the percentage of the population of people aged 65 or over (which is made up of retirees) is 34.11%, and the percentage of people in the range between the 55 and 64 years (those considered as pre-retirees) ”. But nevertheless, a few lines later the age of 64 (pre-retirees) is confused with that of 65 (retirees). Obviously with 64 years you can be pre-retiree but not retiree. We have corrected the error, so that the text would read as follows: “In Spain, for workers in private companies, the mandatory retirement age is 65 years. However, companies in need of reducing their workforce ask the Government to use early retirement, and if the Government approves it, it is possible to retire early, usually between 55 and 64 years of age. Therefore, in the first of the subsamples (active workers) subjects between 50 and 64 years of age were included; in the second of the subsamples (pre-retirees) subjects between 55 and 64 years of age were included; and in the third of the samples (retirees), subjects aged 65 years or more were included. " Thus, the subsamples of active workers and pre-retirees have the same age.

We reiterate our appreciation.

Author Response File: Author Response.pdf

Reviewer 2 Report

Thank you for proper revision of your manuscript and answering for all questions.

I have no objection in publication of you work. 

 

Author Response

Dear reviewer:

Thank you very much and we reiterate our appreciation. A cordial greeting.

Author Response File: Author Response.pdf