Abstract: Emergency Medical Services in Indonesia continue to face challenges, and system operation and resource availability vary from region to region, which may influence the access and utilisation of the services. This study aims to describe the utilisation of EMS in metropolitan and provincial cities in Indonesia. We used a cross-sectional survey design involving patients who attended four general hospitals across the metropolitan city of Jakarta and one hospital in the provincial city of Jayapura in Papua. The questionnaires covered patients' demographic and medical profiles, reasons for choosing the transportation mode, and time related to the emergency event. All patients who attended the hospital emergency departments had equal opportunity to be included, and nurses working at the hospitals administered the questionnaires based on the answers given by the patients. Chi-square and Kruskal-Wallis tests were used to compare the data. A total of 1{,}521 patients gave verbal consent to participate, drawn from the metropolitan (82.1%) and provincial cities (17.9%). Only 10.9% of patients in metropolitan Jakarta and 2.6% in provincial city Jayapura came to the hospital emergency departments in an ambulance, and a high proportion of patients did not know how to contact an ambulance (71.7% in metropolitan and 73% in provincial cities, respectively). The survey, conducted without aggregated EMS data, highlights the need for improved regional and national data collection in Indonesia to enable in-depth analyses of ambulance and hospital service utilisation. The study, covering patient demographics, transport modes and emergency timestamps, is the first to compare metropolitan and provincial contexts. Studies on ambulance utilisation in Indonesia are scarce, and this study serves as an update to a previous study of metropolitan Jakarta and, as far as we are aware, is the first to survey the utilisation of emergency medical services in the provincial city of Jayapura at this level.
@article{brice2025survey,
title = {Survey of ambulance usage by patients in metropolitan and
provincial cities in {I}ndonesia for {E}mergency {M}edical
{S}ervices utilization},
author = {Brice, Syaribah Noor and Harper, Paul and Suhartono, Raden and
Rini, Asti Puspita and Pusponegoro, Aryono Djuned and
Palmer, Geraint and Knight, Vincent A. and Tuson, Mark and
Lloyd, Jennifer and Turnbull-Ross, Jonathan and Gartner, Daniel},
journal = {International Journal of Emergency Services},
volume = {15},
number = {1},
pages = {70--88},
year = {2025},
doi = {10.1108/IJES-02-2024-0010},
url = {https://doi.org/10.1108/IJES-02-2024-0010},
}