Background Pre-hospital and emergency services in Indonesia are still developing. Despite recent improvements in the Indonesian healthcare system, issues with the provision of pre-hospital and emergency services persist. The demand for pre-hospital and emergency services has not been the subject of previous research and, therefore, has not been fully understood. Our research explored the utilization of emergency medical services by patients attending hospital emergency departments in Jakarta, Indonesia. Methods The study used a cross-sectional survey design involving five general hospitals (four government-funded and one private). Each patient’s demographic profile, medical conditions, time to treatment, and mode of transport to reach the hospital were analysed using descriptive statistics. Results A total of 1964 (62%) patients were surveyed. The median age of patients was 44 years with an interquartile range (IQR) of 26 to 58 years. Life-threatening conditions such as trauma and cardiovascular disease were found in 8.6 and 6.6% of patients, respectively. The majority of patients with trauma travelled to the hospital using a motorcycle or car (59.8%). An ambulance was used by only 9.3% of all patients and 38% of patients reported that they were not aware of the availability of ambulances. Ambulance response time was longer as compared to other modes of transportation (median: 24 minutes and IQR: 12 to 54 minutes). The longest time to treatment was experienced by patients with neurological disease, with a median time of 120 minutes (IQR: 78 to 270 minutes). Patients who used ambulances incurred higher costs as compared to those patients who did not use ambulances. Conclusion The low utilization of emergency ambulances in Jakarta could be contributed to patients’ lack of awareness of medical symptoms and the existence of ambulance services, and patients’ disinclination to use ambulances due to high costs and long response times. The emergency ambulance services can be improved by increasing population awareness on symptoms that warrant the use of ambulances and reducing the cost burden related to ambulance use.

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Background Pre-hospital and emergency services in Indonesia are still developing. Despite recent improvements in the Indonesian healthcare system, issues with the provision of pre-hospital and emergency services persist. The demand for pre-hospital and emergency services has not been the subject of previous research and, therefore, has not been fully understood. Our research explored the characteristics of patients attending hospital emergency departments in Jakarta, Indonesia. Methods The study used a cross-sectional survey design involving five general hospitals (four government-funded and one private). The patients’ demographic profile, medical conditions, time to treatment based on different medical conditions, and methods of transport to reach the hospitals were analysed using descriptive statistics. The Kruskal-Wallis test was used to compare groups and the result was considered significant if the p-value < 0.05. Results A total of 1,964 patients was surveyed. The median age of patients was 44 years with an interquartile range (IQR) of 26 to 58 years. IQR describes the range of the middle 50% of values in the data when it is ordered from lowest to highest. Life-threatening conditions such as trauma and cardiovascular diseases were found in 8.6% and 6.6% of patients respectively, the general medical category accounted for 63%. The majority of patients with trauma travelled to the hospital using a motorcycle or car (59.8%). Ambulance was used by 9.3% of the patients, 38% of patients were not aware of the availability of ambulances. The median travel time by ambulances to the hospital was 42 minutes (IQR: 12 to 54 minutes). The median time to treatment for patients with cardiovascular disease was 102 minutes (IQR: 66 to 300 minutes). Conclusion Investing resources in pre-hospital and emergency services in Indonesia and in particular the provision of ambulance services, would create real benefits for the population and result in a significant reduction in deaths following heart disease and stroke.

Previous research has highlighted the significant role social networks play in the spread of non-communicable chronic diseases. In our research, we seek to explore the impact of these networks in more detail and gain insight into the mechanisms that drive this. We use obesity as a case study. To achieve this, we develop a generalisable hybrid simulation and optimisation approach aimed at gaining qualitative and quantitative insights into the effect of social networks on the spread of obesity. Our simulation model has two components. Firstly, an agent-based component mimics the dynamic structure of the social network within which individuals are situated. Secondly, a system dynamics component replicates the relevant behaviours of those individuals. The parameters from the combined model are refined and optimised using longitudinal data from the United Kingdom. The simulation produces projections of Body Mass Index broken down by different age groups and gender over a 10-year period. These projections are used to explore a range of scenarios in a computational study designed to address our research aims. The study reveals that, for the youngest population sub-groups, the network acts to magnify the impact of external and social factors on changes in obesity, whereas, for older sub-groups, the network mitigates the impact of these factors. The magnitude of that impact is inversely correlated with age. Our approach can be used by public health decision makers as well as managers in adult weight management services to enhance initiatives and strategies intended to reduce obesity. Our approach is generalisable to understand the impact of social networks on similar non-communicable diseases.