The Pre-Hospital and Healthcare System in Malang, Indonesia

Abstract

Introduction Malang is the second largest city in East Java and consists of three districts: Malang Regency, Malang City and Batu City. Malang has the most advanced emergency care education in East Java, and possibly Indonesia. The recent launch of the 119 Emergency Medical Service may influence pre-hospital care in Malang and assist in developing a more organised emergency medical system in the area. Objective This paper describes the pre-hospital care and healthcare structure in Malang and focuses on the health facilities, pre-hospital care service and healthcare providers. Discussion There are two major types of healthcare facilities in Malang, hospitals and primary healthcare centres called ‘puskesmas’. Ambulance service provision in Malang is either hospital-based or puskesmas-based. There is no organised emergency medical system in Malang. In the case of an emergency, the patient or bystander calls the hospital emergency department or puskesmas. The use of ambulances in Malang is low due to the perceived prohibitive cost of the service. Ambulance service fees for emergency cases outside of the hospital or puskesmas are not covered by the universal health insurance in the country. There is no specific pre-hospital trained staff in Malang. Nurses are responsible for staffing the ambulance, and there is no formal pre-hospital care education for those nurses working in an ambulance.