Snapshot of emergency departments in Jakarta, Indonesia

Abstract

Objective: EDs in Indonesia face an unprecedented increase in patient influx after the expansion of national health insurance system coverage. The present study aims to describe EDs' characteristics and capabilities utilisation in Jakarta. Methods: An ED inventory was created from the Jakarta Provincial Health Office and the Indonesian Hospital Association registries. The EDs that were accessible to the general public 24/7 were surveyed about their characteristics during the calendar year 2017. For further ED analysis, we stratified the hospitals into four types (A, B, C and D) based on their size and capabilities, with type A being the largest. Results: From the 118 (81%) out of 146 EDs that responded, there were 2 million ED visits or 202 per 1000 people. The median annual visit volume was 11 200 (interquartile range 4233-18 000). Further stratification highlights the annual visit difference among hospital types where type A hospitals reported the most with 32 000 (interquartile range 13 459-38 873). Almost half of the EDs (47%) answered that ≥60% of the inpatient census came from the ED. Less than half of the EDs (44%) can manage psychiatry, oral-maxillofacial and plastic surgery cases. Consultant coverage varied across hospitals and by hospital type (P < 0.05), except for general surgery and obstetrics and gynaecology consultants who were available in most hospitals (74%). Conclusion: Physicians with limited experience and EDs with heterogeneous emergency care capabilities likely threatened the consistency of quality emergency care, particularly for time-sensitive conditions. Our study provides a benchmark for future improvements in emergency care.

Emergency intubation practices in a tertiary teaching hospital in Jakarta, Indonesia: A prospective observational study

“…Indonesia currently recognises emergency medicine as a specialisation 1 . The Indonesian medical education system only allows universities to run residency programme for medical specialty training under the Ministry of Education.…”

“…Indonesia currently recognises emergency medicine as a specialisation. 1 The Indonesian medical education system only allows universities to run residency programme for medical specialty training under the Ministry of Education. However, most hospitals are under the Ministry of Health and therefore only a limited number of training programmes are available in the few academic hospitals affiliated with universities.…”

“…Emergency endotracheal intubation is a vital skill for ED doctors. Most ED doctors in Indonesia are non‐specialist doctors because Indonesia has only one formal emergency medicine specialist programme hitherto and there are a limited number of training positions 1 . Although endotracheal intubation is a part of the general physician's core competencies, intubation in emergency patients differs significantly from that involving intensive care units (ICUs) or elective surgery patients.…”

Survey on emergency care utilization in tertiary care hospitals in Indonesia

“…Indonesia has the fourth largest population in the world. While recent socio-economic changes and increased life expectancy have led to a growing demand for emergency medical services (EMS), 1 the emergency care system in Indonesia, encompassing EMS and emergency departments (ED), remains suboptimal. 2 For example, the mortality rate from road traffic accidents per 100,000 population in Indonesia (12.2) was three or four times compared to those in nearby countries such as Singapore (2.8), Australia (5.6) or Japan (4.1).…”

Emergency Nurses’ Competency in the Emergency Department Context: A Qualitative Study

“…Additionally, Indonesia’s geographical conditions result in a high risk of experiencing natural disasters. 9 , 10 These conditions impact the complexity of the nursing work in EDs. Concurrently, this is reflected in the need for competent emergency nurses to support safe and quality health services provided in the form of daily emergency care services and their response in disaster situations.…”