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Objectives To investigate the implementation of teleconsultation and assess the level of readiness for its adoption among various types of healthcare facilities Methods This cross-sectional study involved medical doctors working in a public hospital, a private hospital, and community health centers in Yogyakarta, Indonesia. We recruited 29 medical specialists from various departments in two hospitals and 27 heads of community health centers. The readiness items were categorized into sections that encompassed various readiness areas such as core, technological, motivational, learning, work culture, and policy readiness. Data were analyzed using a one-way analysis of variance and the Kruskal-Wallis test to evaluate differences in levels of readiness across healthcare facilities. A logistic regression analysis was conducted to further assess factors predicting the implementation of teleconsultation. Results Variations in technological readiness were observed between the community health centers and the public hospital (p = 0.006) and the private hospital (p = 0.007). Differences in learning readiness were found between the public hospitals and private hospitals (p = 0.01). There were also disparities in cultural readiness between the public hospital and the private hospital (p = 0.04) and between public hospital and community health centers (p = 0.01). Logistic regression revealed an association between technological readiness and the use of video teleconsultation (OR = 1.13; p = 0.017). The private hospital was more likely to implement video-based teleconsultation than was the public hospital (OR = 2.68; p = 0.003) or community health centers (OR = 3.13; p ≤ 0.001). Conclusion Significant differences in technology readiness were identified among community health centers, public hospitals, and private hospitals. Future policy implementation should focus on customizing technology use and providing cultural training to help healthcare institutions with different technological readiness levels.

BackgroundThe long-acting reversible contraceptive method is one way to overcome the high population growth rate. The long-term contraception method is more efficient to regulate pregnancy because it can be used for a long period of time and is safer and more effective and the failure rate is relatively low at 0.2 per 100 users. The strong patriarchal culture in the Special Region of Yogyakarta is one of the factors that determine the wife's decision to use the long-term contraception method. Therefore, this study aims to determine the effect of knowledge, attitudes, and support from husbands in the use of the LARC method in the Special Region of Yogyakarta. MethodThis study used secondary data from the 2017 Indonesia Demographic and Health Survey (IDHS) taking the Special Region of Yogyakarta province as a level of analysis or as a place of research. The population was all fertile couples aged 15–49 years as many as 123 couples. The sample was as many as 71 respondents who had made the inclusion criteria refer to criteria used in the 2017 IDHS, namely fertile age couple who used LARC and non-LARC contraception. Data were analyzed by multivariate analysis.ResultsThe results showed that there is no relationship between husband's knowledge (p value = 0.330), husband's attitude (p value = 1.000), and husband's support (p value = 0.771) on the choice of LARC in the Special Region of Yogyakarta.ConclusionEven though in a patriarchal culture, husbands do not play a major role in contraceptive choices because of the presence of women empowerment and misinformation about the contraceptive method itself, close communication between husband and wife and the socialization of LARC by health workers is expected to increase its use.

Given the increasing burden of chronic diseases in Indonesia, characteristics of chronic multimorbidities have not been comprehensively explored. Therefore, this research evaluated chronic multimorbidity patterns among Indonesians using Indonesian National Health Insurance (INHI) sample data. We included 46 chronic diseases and analyzed their distributions using population-weighted variables provided in the datasets. Results showed that chronic disease patients accounted for 39.7% of total patients who attended secondary health care in 2015–2016. In addition, 43.1% of those were identified as having chronic multimorbidities. Findings also showed that multimorbidities were strongly correlated with an advanced age, with large numbers of patients and visits in all provinces, beyond those on Java island. Furthermore, hypertension was the leading disease, and the most common comorbidities were diabetes mellitus, cerebral ischemia/chronic stroke, and chronic ischemic heart disease. In addition, disease proportions for certain disease dyads differed according to age group and gender. Compared to survey methods, claims data are more economically efficient and are not influenced by recall bias. Claims data can be a promising data source in the next few years as increasing percentages of Indonesians utilize health insurance coverage. Nevertheless, some adjustments in the data structure are accordingly needed to utilize claims data for disease control and surveillance purposes.