Efficiency of Healthcare Financing: Case of European Countries
Round 1
Reviewer 1 Report
Comments and Suggestions for Authors
Thanks for the opportunity to review this paper. I recommend to (1) cite the recent papers finding the importance of quality of governance for health outcomes, (2) include a governance or corruption variable as an additional control variable, (3) compare the estimated coefficients with the literature, and (4) show more necessary statistics in the result tables.
1. The following papers recently found that quality of governance of government operations matters for health outcomes. Would you be able to control for governance or corruption issues by including governance indicators? Also, these papers used the same dependent variable (life expectancy) and similar explanatory variables such as domestic private health expenditure. Please discuss how the sizes of estimated coefficients differ from the previous literature.
Nakatani, Ryota & Qianqian Zhang & Isaura Garcia Valdes, 2022. "Fiscal Decentralization Improves Social Outcomes When Countries Have Good Governance," IMF Working Papers 2022/111, International Monetary Fund.
Nakatani, Ryota & Qianqian Zhang & Isaura Garcia Valdes, 2024. "Health Expenditure Decentralization and Health Outcomes: The Importance of Governance," Publius: The Journal of Federalism, Vol. 54(1), pages 59-87.
2. Please show the number of observations, R-squared, time period of data, and the number of countries in the results Tables 3 and 4.
Author Response
Dear Reviewer,
Thank you very much for your time and valuable comments.
We are sending you our point-by-point response to your comments in the attachment.
All changes are highlighted in yellow.
Best regards,
Aleksy Kwilinski
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for Authors
Dear author, I appreciate for the invitation to review this manuscript. I have several concerns shown as below.
(1) The research contribution of this article is unclear. I suggest a clearer statement of "what has been done in previous studies?", "what's the research limitations of prior investigations?", "what research gap this study is to fill?" etc. in the end of the introduction section.
(2) In the abstract, the authors argue that they focus on the relation between healthcare financing and outcome. Then, what"s the outcome specifically indicate? Does it mean solely the life expectancy? How is the efficiency of healthcare financing understood as shown in the article title?
(3) The results of table 2-5 should be more clearly explained. Why three clustered is yield in the statistical analysis? What's the comparison among the three clusters implies?
(4) I suggest the review and citation of some literature about healthcare financing in rcent five years to enhance this article.
Li, J., & Yuan, B. (2019). Understanding the effectiveness of government health expenditure in improving health equity: preliminary evidence from global health expenditure and child mortality rate. The International journal of health planning and management, 34(4), e1968-e1979.
Alipouri Sakha, M., Bazyar, M., & Rashidian, A. (2024). Classification and focus comparison of health financing frameworks: A scoping review. The International Journal of Health Planning and Management.
Gaylong, R., Tiwari, V. K., & Sherin Raj, T. P. (2023). Planning and financing of RMNCH+ A under National Health Mission: A case study of the Gurugram District of Haryana State. The International Journal of Health Planning and Management, 38(4), 951-966.
Novignon, J., & Tabiri, K. G. (2022). Leveraging COVID‐19 pandemic response for improved health system financing: Lessons from Ghana. The International Journal of Health Planning and Management, 37(4), 2211-2223.
Sarker, A. R., Sultana, M., Alam, K., Ali, N., Sheikh, N., Akram, R., & Morton, A. (2021). Households' out‐of‐pocket expenditure for healthcare in Bangladesh: A health financing incidence analysis. The International Journal of Health Planning and Management, 36(6), 2106-2117.
Domapielle, M. K., Sumankuuro, J., & Bebelleh, F. D. (2022). Revisiting the debate on health financing in Low and Middle‐income countries: An integrative review of selected models. The International Journal of Health Planning and Management, 37(6), 3061-3074.
Comments on the Quality of English Language
The language is acceptable.
Author Response
Dear Reviewer,
Thank you very much for your time and valuable comments.
We are sending you our point-by-point response to your comments in the attachment.
All changes are highlighted in yellow.
Best regards,
Aleksy Kwilinski
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for Authors
We appreciate that the paper may be a good contribution to the literature. We suggest to the authors:
- to add at the end of the Introduction section the aim of the research and to mention how the paper is structured (the main parts);
- to add the research questions/research assumptions;
- to mention the source below each figure/table;
- to present the research results only in the Results section;
- to discuss the research results in the light of other studies and research;
- to not present in the Discussion section elements that are specific to Material and Methods or Results section (e.g., "Based on the input parameters of the healthcare financing, cluster analysis in Stata 428 14.2/SE software product was realized. 34 studied European countries were grouped into 3 clusters" should be specified in Material and Methods section;
- to separate the results discussions from the conclusions;
- to highlight better the own contributions of the research, the usefulness of the research, and future research directions;
- to illustrate in what measure this aim was achieved - "to identify specific patterns of the healthcare financing models and formalize certain steps that will increase their efficiency formalize certain steps that will increase their efficiency."
Author Response
Dear Reviewer,
Thank you very much for your time and valuable comments.
We are sending you our point-by-point response to your comments in the attachment.
All changes are highlighted in yellow.
Best regards,
Aleksy Kwilinski
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for Authors
Thank you for your response.
Reviewer 2 Report
Comments and Suggestions for Authors
The revised manuscript has shown much improvement. Overall, the present form is publishable. However, I have a final suggestion for authors' reference. It would be better to place some subsections in the "material and method" part (e.g., data source, variables, analysis approach, etc.).
Reviewer 3 Report
Comments and Suggestions for Authors
We appreciate that the authors have considered our recommendations and made the improvements.
