How Does the COVID-19 Pandemic Affect People’s Willingness to Pay for Health in the Short and Long Term? A Longitudinal Study during and after the COVID-19 Pandemic in China
Round 1
Reviewer 1 Report
Dear authors,
Thank you for submitting this manuscript. The title of the paper is interesting and challenging. It invites readers to become curios to find out if and how their willingness to pay for health has been influenced by the pandemic context. The aim of the paper is to reveal the differences on short and long term in the pandemic impact on the willingness to pay for health.
- General comments
The title refers to two periods of time – during and after the pandemic in China, while the abstract and the paper mention about a period such as “after the pandemic had been brought under control”. Is this after the pandemic had been brought under control the same thing with the “after the COVID-19 pandemic” from the title? (example - Lines 4-5 versus 25-26 etc). In addition, the authors should clarify the difference between short and long term? Does long term really mean one year and a half?
Suggestions: Please provide clarifications on the concepts of the periods considered in the study, as well as for the short and long term.
- Specific comments
Lines 29-61: The Introduction does not place the study in a broad context and there is not enough highlight why this study is important. Which are the general determinants of the people’s willingness to pay for health? The introduction section should come with the current state of the research field which should be carefully reviewed and key publications cited. There is a lot of room to add more citations.
Lines 42-45: the negative impact of the pandemic is cited, while the positive effects of the pandemic, no.
Suggestions: Please reconsider the introduction section. Develop the literature review for describing the context of the research. Cite the research when mentioning the positive effects of the pandemic.
Lines 155-168: The first questionnaire was based on 1548 participants, but there is no clarification on the sampling method? Was it convenience sampling? All the questionnaires were valid? How did the respondents find out of the questionnaire placed on the Credamo platform? Have they received e-mails? If yes, what percentage of the people receiving e-mails decided to answer? In addition, why was the reward needed for the respondents and which was the fund this monetary reward came from?
Suggestions: Please clarify the abovementioned issues on sampling and valid responses of the participants, as well as of their motivational reward.
Lines 181-183: The indicators published by the National Health Commission of the People’s Republic of China are used in the paper, but no reference for them.
Suggestions: Cite the indicators abovementioned.
Lines 198-203: The statistical analysis of the reliability and validity of the four variables is clear, but there is no evidence on the software used.
Suggestions: Please, clarify on the statistical tool/software that was used.
The research might generate an overall benefit to publishing this work, under some minor revision/corrections. The work will provide an advance towards the current knowledge. English language is appropriate and understandable.
Author Response
Comments and Suggestions for Authors
Dear authors,
Thank you for submitting this manuscript. The title of the paper is interesting and challenging. It invites readers to become curios to find out if and how their willingness to pay for health has been influenced by the pandemic context. The aim of the paper is to reveal the differences on short and long term in the pandemic impact on the willingness to pay for health.
- General comments
The title refers to two periods of time – during and after the pandemic in China, while the abstract and the paper mention about a period such as “after the pandemic had been brought under control”. Is this after the pandemic had been brought under control the same thing with the “after the COVID-19 pandemic” from the title? (example - Lines 4-5 versus 25-26 etc). In addition, the authors should clarify the difference between short and long term? Does long term really mean one year and a half?
Suggestions: Please provide clarifications on the concepts of the periods considered in the study, as well as for the short and long term.
Response: Thank you for your suggestion. We have clarified the abovementioned issues in the revised manuscript. Please see Line 82-93 for details.
- Specific comments
Lines 29-61: The Introduction does not place the study in a broad context and there is not enough highlight why this study is important. Which are the general determinants of the people’s willingness to pay for health? The introduction section should come with the current state of the research field which should be carefully reviewed and key publications cited. There is a lot of room to add more citations.
Lines 42-45: the negative impact of the pandemic is cited, while the positive effects of the pandemic, no.
Suggestions: Please reconsider the introduction section. Develop the literature review for describing the context of the research. Cite the research when mentioning the positive effects of the pandemic.
Response: Thank you for your suggestion. We have rewritten the introduction section and enhanced the citation of literature in the revised manuscript. Please see Line 30-82 for details.
Lines 155-168: The first questionnaire was based on 1548 participants, but there is no clarification on the sampling method? Was it convenience sampling? All the questionnaires were valid? How did the respondents find out of the questionnaire placed on the Credamo platform? Have they received e-mails? If yes, what percentage of the people receiving e-mails decided to answer? In addition, why was the reward needed for the respondents and which was the fund this monetary reward came from?
Suggestions: Please clarify the abovementioned issues on sampling and valid responses of the participants, as well as of their motivational reward.
Response: Thank you for your suggestion. We have clarified the abovementioned issues in the revised manuscript. Please see Line 218-231 for details.
Lines 181-183: The indicators published by the National Health Commission of the People’s Republic of China are used in the paper, but no reference for them.
Suggestions: Cite the indicators abovementioned.
Response: Thank you for your suggestion. We have added the corresponding reference in the revised manuscript. Please see Line 49 for details.
Lines 198-203: The statistical analysis of the reliability and validity of the four variables is clear, but there is no evidence on the software used.
Suggestions: Please, clarify on the statistical tool/software that was used.
Response: Thank you for your suggestion. We have introduced the software that we used in the revised manuscript. Please see Line 268 for details.
The research might generate an overall benefit to publishing this work, under some minor revision/corrections. The work will provide an advance towards the current knowledge. English language is appropriate and understandable.
Reviewer 2 Report
The goal of the paper: "This study evaluated the short- and long-term effects of the COVID-19 pandemic on people’s willingness to pay for health (WPH) by conducting three longitudinal surveys" (lines 14-15) is rather vague. Why not to refer to three research questions? (lines 50-53).
The term “the psychological mechanism” in research question no. 2 cannot be reduced just to self-esteem.
Since fear of death is the mediating variable (lines 189-190) why the number of deaths is missed among the independent variables?
The correlation between high self-esteem and control variables (lines 194-197) would put some more light on the findings.
Author Response
Comments and Suggestions for Authors
The goal of the paper: "This study evaluated the short- and long-term effects of the COVID-19 pandemic on people’s willingness to pay for health (WPH) by conducting three longitudinal surveys" (lines 14-15) is rather vague. Why not to refer to three research questions? (lines 50-53).
Response: Thank you for your suggestion. We have rewritten the aims of our study in the revised abstract. Please see Line 14-18 for details.
The term “the psychological mechanism” in research question no. 2 cannot be reduced just to self-esteem.
Response: Thank you for your suggestion. We have clarified the psychological mechanism more precisely in the revised abstract. Please see Line 75-80 for details.
Since fear of death is the mediating variable (lines 189-190) why the number of deaths is missed among the independent variables?
Response: Thank you for your suggestion. We have clarified why we didn’t use the indicator of the numbers of deaths caused by COVID-19 in the revised manuscript. Please see Line 253-254 for details.
The correlation between high self-esteem and control variables (lines 194-197) would put some more light on the findings.
Response: Thank you for your suggestion. We have analyzed the relation between control variables and dependent variable in the revised manuscript. Please see Line 293-300 for details.
Reviewer 3 Report
The article presented for review raises a very interesting and important from the cognitive and practical point of view problem of the relationship of the Covid-19 pandemic with the propensity of consumers to incur health-related expenses.
The strength of the text is undoubtedly the concept of the study, the scope of analysis conducted, the statistical methods used to develop the data collected as a result of empirical research. Also the conclusions of the research problems identified by the authors, as well as the final conclusion do not raise objections.
However, the chapter Introduction leaves a certain dissatisfaction, as it contains statements that have not been documented in the literature in any way, e.g.
"In those 2 years, the way that people worldwide live has dramatically changed, and people have gradually adjusted their behavior to the impact of the pandemic "(line 32).
A broader description of the context of the research undertaken would have been helpful, rather than a reference to just one previous article (line 36).
The theoretical background chapter is much better - the theses are convincing, although their literature support is moderate. Nevertheless, the research hypotheses are not objectionable.
Another weak point of the text is the discussion. It is limited to the presentation of the theoretical contribution of the obtained results, their practical implications and indication of potential (very interesting) directions for future research. However, it contains practically no comparisons of the obtained results to the results of other studies - and this is, after all, the main assumption of this chapter. In recent years, a number of articles have been written on the impact of the Covid-19 pandemic on consumer behavior (including health-seeking behavior). At least a few of them address the impact of health and life concerns resulting from the pandemic on consumption behavior.
As a consequence of these shortcomings, the bibliography is limited to only 20 references, which seems to be too few for an interdisciplinary article.
To sum up, I suggest a broader treatment of the issue of changes in human behavior as a result of the Covid-19 pandemic in the introduction and a deeper discussion of the results. Technically, I suggest adding legends under Tables 1 and 2 describing the abbreviations used in the tables and presentation of the items of the Rosenbarg scale (line 193).
In spite of the above comments, I consider the text to be of great value and hope that it will be published after the suggested changes are made.
Author Response
Comments and Suggestions for Authors
The article presented for review raises a very interesting and important from the cognitive and practical point of view problem of the relationship of the Covid-19 pandemic with the propensity of consumers to incur health-related expenses.
The strength of the text is undoubtedly the concept of the study, the scope of analysis conducted, the statistical methods used to develop the data collected as a result of empirical research. Also the conclusions of the research problems identified by the authors, as well as the final conclusion do not raise objections.
However, the chapter Introduction leaves a certain dissatisfaction, as it contains statements that have not been documented in the literature in any way, e.g."In those 2 years, the way that people worldwide live has dramatically changed, and people have gradually adjusted their behavior to the impact of the pandemic "(line 32).
A broader description of the context of the research undertaken would have been helpful, rather than a reference to just one previous article (line 36).
The theoretical background chapter is much better - the theses are convincing, although their literature support is moderate. Nevertheless, the research hypotheses are not objectionable.
Another weak point of the text is the discussion. It is limited to the presentation of the theoretical contribution of the obtained results, their practical implications and indication of potential (very interesting) directions for future research. However, it contains practically no comparisons of the obtained results to the results of other studies - and this is, after all, the main assumption of this chapter. In recent years, a number of articles have been written on the impact of the Covid-19 pandemic on consumer behavior (including health-seeking behavior). At least a few of them address the impact of health and life concerns resulting from the pandemic on consumption behavior.
As a consequence of these shortcomings, the bibliography is limited to only 20 references, which seems to be too few for an interdisciplinary article.
To sum up, I suggest a broader treatment of the issue of changes in human behavior as a result of the Covid-19 pandemic in the introduction and a deeper discussion of the results.
Response: Thank you for your suggestion. We have rewritten the introduction section and enrich the discussion section in the revised manuscript. Please see Line 30-82 and Line 357-375 for details.
Technically, I suggest adding legends under Tables 1 and 2 describing the abbreviations used in the tables and presentation of the items of the Rosenbarg scale (line 193).
Response: Thank you for your suggestion. We have added information under Tables describing the abbreviations used in the tables as well as added an Appendix listing the items of Rosenbarg’s scale.
In spite of the above comments, I consider the text to be of great value and hope that it will be published after the suggested changes are made.
