Factors of the Revisit Intention of Patients in the Primary Health Care System in Argentina

Round 1

Reviewer 1 Report

 

The authors studied how the quality of health services for primary care in Argentina affects patients' intention to revisit the hospital. In their survey, 407 patients were selected and given a questionnaire about their attributes and the quality of the health program. Through PLS-SEM analysis, they found that service quality influenced the intention to revisit significantly.

 This paper is well detailed in its discussion of the data and results. The obtained hypotheses are interesting. However, I think the description related with PLS-SEM is not clear. I recommend that the authors consider the following points.

- How was the model in Figure 1 created? Is there some basis for each line? For example, why Satisfaction is connected with Trust? The method used to create the model should be explained.

- In PLS-SEM, is it possible to show fit indicators such as SMAR and STDCR? In general, SEM-based methods are required to indicate the adaptability of fitting to the model.

- I recommend that the authors describe details of the bootstrap performed in the hypotheses. For example, sample size, model used, and fit indicators.

 

Author Response

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Reviewer 2 Report

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Comments for author File: Comments.pdf

Author Response

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Reviewer 3 Report

Dear authors,

- I recommend adding information about the research sample, from the point of view of research, this data is very important,

- the results achieved by the authors could have been elaborated in more detail,

- finalize the conclusion

 

Author Response

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Reviewer 4 Report

Dear authors:

The manuscript discussed the factors influencing patients' revisit intention to the primary care system, which provides an interesting perspective to the academic field. The manuscript, however, has some content and format issues that can not be neglected. To help the authors provide a quality job, here is some advice:

 

In the abstract part, an abstract is a brief description containing the background, objective, methods, results, and conclusion of the study. The content of page 1, lines 18-20, "The quality of care was measured considering four dimensions: Quality of the use of health programs, Satisfaction, Confidence and Revisit Intention," is inaccurate since the four so-called dimensions by the authors are variables. And the content of lines 25-29, "Users of the health service must perceive a high... so that he finally revisit intention," can be replaced by a brief conclusion and implication of the study.

 

In the introduction part, firstly, the content of page 2, lines 68-80, describes the relationships between quality of the use of health programs, satisfaction, confidence, and revisit intention. It would be much more acceptable if the authors could create a new paragraph to sort out the relationships and move the hypotheses (e.g., page 9, lines 368-370) to this part. Secondly, we can see the description on page 2, lines 81-90, is trying to emphasize the study's value and contributions, which is apparently not persuasive. I recommend the authors clarify why is the quality of care in the primary health care system in Rosario, Argentina important, and head this logic down the study contributions instead of self-certified description. Thirdly, the connection between the manuscript and the scopes and aims of Sustainability is not reflect.

 

The methodology part, firstly, lacks the content of the measurements of variables and the data collection process. And it is necessary to report there are no ethical considerations of respondents since the sensibility of the study themes.

 

The data analysis process missed the model fit test in the results part. And, it seemed the results of the discriminant validity examination did not pass the acceptable level (the value of the correlation values of trust and satisfaction), and there is no explanation for it. Then, the analysis of demography information needs to be streamlined and moved before CFA. At last, there is a lack of description in Table 3 and Table 4 in the study. At last, for aesthetic purposes, the authors need to adjust the conceptual model.

 

In the discussion part, the authors fail to capture the point of writing, which makes this part disordered. And the description of the impact of demographic variables on respondents' intention to revisit primary health care is lengthy, and it is hard to conduct such conclusions due to the above analysis. A multi-group analysis is needed if the authors want to explore the demography role.

 

In the conclusion part, what the authors wrote is not impressive and persuasive, leading to a low illuminating of the study.

 

As a whole, there are sentences facing unclear or hard-to-know problems, and a careful self-check is necessary. 

 

Author Response

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Round 2

Reviewer 1 Report

The authors have responded to comments appropriately. I believe the paper is acceptable.

Author Response

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Reviewer 2 Report

The author has addressed most of my questions, especially regarding the ethical application of the questionnaire. But there are still some small problems that need to be corrected by the authors.

1. The most prominent problem at present is the expression of logical structure between paragraphs. Especially the introduction and the discussion. Take the discussion section as an example. It contains too much text. Please reduce it to about five paragraphs. In addition, please incorporate the research hypothesis into the previous text, rather than writing too long at the end.

2. On the whole, there are a lot of references, but the references to other countries are still relatively few. It is suggested to delete some domestic literatures and increase literatures from other countries (e.g. The Impact of Dependency Burden on Urban Household Health Expenditure and Its Regional Heterogeneity in China: Based on Quantile Regression Method. Front. Public Health，2022，10:876088. doi: 10.3389/fpubh.2022.876088).

3. Is it possible to consider integrating 2. Theoretical Framework into 3. Methodology?

On the whole, this version is much better than the first draft, but it still needs to address the above three issues before it is suitable for publication in this publication.

Author Response

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Reviewer 4 Report

Dear authors:

We can see the authors have taken the advice, and the manuscript has improved dramatically. I'd appreciate the authors' efforts and determination. However, before the manuscript being accepted, I recommend the authors recheck the details of the manuscript.

Firstly, I'm afraid the reason why Sustainability is still in lack. I recommend the authors spend some time reading the aims and scopes of Sustainability and ensure it can be seen in the manuscript.

Secondly, in the results section, demographic data content needs to be pruned back. And there is a lack of the title of the data validation part. Besides, the factor loadings of the items need to be presented in table 2 too. In the discriminant validity part, a value in table 3 didn't pass the Fornell-Larcker criterion, which the authors still didn't explain. And what did the authors expect the readers to see in table 4? At last, the model conception in Figure 2 is far from clear and beautiful. I recommend the authors look at some empirical studies and learn from their model drawing skills.

Thirdly, the table format needs to conform to that request for Sustainability.

As a whole, a paper's writing ability still needs the authors take more time to learn. For now, there is a particular gap between the manuscript and an SSCI journal; we can see this, especially in abstract section, introduction section, and discussion section. It would be much more acceptable for the manuscript if the authors studied high-quality papers carefully and learned the writing logic.

Author Response

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Round 3

Reviewer 4 Report

Dear authors:

 

We can see a massive improvement in the paper's writing ability, especially in the introduction and discussion sections, which makes the whole manuscript more readable. And the authors also replenished the reasonable explanation of the relationship between the manuscript and Sustainability.

For now, the main issue of the manuscript remains in the data analysis section. Firstly, I recommend the authors unify the format of tables according to the request of Sustainability. And the information in table 2 is incomplete. Secondly, it seems that the discriminant validity analysis results are different from that in the last manuscript. Technically, The discriminant validity is determined by comparing each construct's AVE square root value with the correlation coefficients of other constructs. The values should've been the same even if the change in the sequence of constructs. I hope the authors explain this. And the manuscript said there are three methods that examine the discriminant validity, while the following content didn't show yet. Thirdly, the NFI value at the model fit analysis is far from the criteria level, which means the model fit did not pass. I recommend the authors check the data analysis process and, if possible, do it again to see if something is wrong.

Author Response

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