Survey of ambulance usage by patients in metropolitan and provincial cities in Indonesia for Emergency Medical Services utilization

Purpose Emergency Medical Services in Indonesia continue to face challenges. The system operation and resource availability vary from region to region which may influence the access and utilization of the services. The study aims to describe the utilization of EMS in metropolitan and provincial cities in Indonesia. Design/methodology/approach 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. Nurses working at the hospitals administered the questionnaires based on the answers given by the patients. Statistical tests such as Chi-square and Kruskal–Wallis were used to compare the data. Findings A total of 1,521 patients gave verbal consent to participate. The samples were composed of those patients 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. A high proportion of patients did not know how to contact an ambulance (71.7% in metropolitan and 73% in provincial cities, respectively). Practical implications 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 utilization. The study, covering patient demographics, transport modes and emergency timestamps, is the first to compare metropolitan and provincial contexts. Despite limitations, the findings offer valuable insights into EMS use and underscore the need to enhance equity, accessibility and quality of emergency services across the country. Originality/value Studies on ambulance utilization in Indonesia are scarce. This study serves as an update to the previous study for metropolitan Jakarta, and as far as the authors’ knowledge, this is the first study that surveyed the utilization of emergency medical services in the provincial city of Jayapura at this level.