Endometriosis Care in the Indonesian Healthcare Referral System: Evaluating Diagnostic Delays and Therapeutic Approaches

Endometriosis Care in the Indonesian Healthcare Referral System: Evaluating Diagnostic Delays and Therapeutic Approaches | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Endometriosis Care in the Indonesian Healthcare Referral System: Evaluating Diagnostic Delays and Therapeutic Approaches Kanadi Sumapraja, Rebecca Octavia Fransisca, Raja Yasmin Khalilah, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4429040/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Background Endometriosis, a prevalent gynecological disorder, poses significant challenges in diagnosis and treatment, often leading to delayed care and compromised quality of life. With the implementation of the Indonesian National Health Insurance, understanding the diagnostic and treatment patterns for endometriosis becomes crucial in this evolving healthcare framework. This study aims to evaluate prehospital treatment patterns of endometriosis patients before referral to tertiary healthcare within the Indonesian National Health Insurance era. Methods A descriptive study involving 30 female patients diagnosed with endometriosis was conducted at a tertiary hospital in Jakarta, Indonesia. Data collection included structured interviews and retrieval of secondary data from health records. Descriptive analysis was performed using SPSS software. Results The study revealed a mean age of 36.3 years among respondents, with diverse manifestations of endometriosis, including adenomyosis, cysts, and deep infiltrating endometriosis. Patients experienced symptoms for an average of 8.5 years before seeking tertiary care, with significant reliance on pharmacological interventions such as NSAIDs and hormonal therapies. Surgical interventions, primarily cystectomy, were also common, with 40% of respondents undergoing surgery. The study highlighted care coordination challenges and delays in diagnosis and treatment initiation. Conclusions The study reveals significant delays in diagnosing and treating endometriosis under the Indonesian National Health Insurance system. Improved awareness, education, and multidisciplinary approaches are essential to enhance early detection and optimize patient outcomes globally and within the Indonesian National Health Insurance framework. Endometriosis Health Care Delivery Health Services Accessibility Insurance Referral and Consultation Full Text Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Reject after peer review 30 Jul, 2024 Reviewers agreed at journal 03 Jun, 2024 Reviewers invited by journal 02 Jun, 2024 Editor invited by journal 30 May, 2024 Editor assigned by journal 16 May, 2024 First submitted to journal 15 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4429040","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":309701453,"identity":"763565a3-9318-4256-92e8-13e017d5388c","order_by":0,"name":"Kanadi Sumapraja","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABD0lEQVRIiWNgGAWjYBADZgYeEMUmIQeiDjwgRYsxWEsCUfZAtDAkNoBofFrkZ2Qnfi7cY8fO33P42YMfZRbp88MOPwTaYien24Bdi8GN3M3SM54lM0ucbTM37DknkbvxdpoBUEuysdkBHFokcjdI8xxgZmY4z2AmwdsG1DI7AaTlQOI2HFrkZ+Ru/s1zoJ5Z/jz7N8m/bRLphrPTP+DVwnAjdxvQlsPMBmd7zKSBtiTIS+fgt8XgzNtt1jMOHGc2PHOmTFrmnIThBumcggMJBrj9It+eu/l2wYHqZLkz6dsk35TVycvPTt/84UOFnRwuLSDADMTJCHvBKg1wK4dpsUPY24Bf9SgYBaNgFIw8AAA2EWAz01zrOwAAAABJRU5ErkJggg==","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":true,"prefix":"","firstName":"Kanadi","middleName":"","lastName":"Sumapraja","suffix":""},{"id":309701454,"identity":"33063d3e-a30d-46c4-9d8b-5cb89d6ae6c1","order_by":1,"name":"Rebecca Octavia Fransisca","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Rebecca","middleName":"Octavia","lastName":"Fransisca","suffix":""},{"id":309701455,"identity":"b08de18d-e618-44b9-9598-60a31e134ec5","order_by":2,"name":"Raja Yasmin Khalilah","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Raja","middleName":"Yasmin","lastName":"Khalilah","suffix":""},{"id":309701456,"identity":"28bd7efa-94b2-444f-90ff-13fd356bd915","order_by":3,"name":"Muhammad Ikhsan","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Muhammad","middleName":"","lastName":"Ikhsan","suffix":""},{"id":309701457,"identity":"9c0c2501-5a94-48a8-9f3a-5500e4a9d81c","order_by":4,"name":"Achmad Kemal Harzif","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Achmad","middleName":"Kemal","lastName":"Harzif","suffix":""},{"id":309701458,"identity":"3affe171-98e0-4473-94c6-f9643e8fe1f6","order_by":5,"name":"Mila Maidarti","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Mila","middleName":"","lastName":"Maidarti","suffix":""},{"id":309701459,"identity":"48a90419-6562-4eac-a1b2-dbafe3bb690c","order_by":6,"name":"Budi Wiweko","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Budi","middleName":"","lastName":"Wiweko","suffix":""},{"id":309701460,"identity":"4ae52179-4ffa-42a2-be1e-7c5989de55ab","order_by":7,"name":"Raden Muharam","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Raden","middleName":"","lastName":"Muharam","suffix":""},{"id":309701461,"identity":"d506e683-a47d-406d-b908-6b56dc412220","order_by":8,"name":"Gita Pratama","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Gita","middleName":"","lastName":"Pratama","suffix":""},{"id":309701462,"identity":"b9a20c63-dcb0-45e4-8145-be68a35b6ba2","order_by":9,"name":"Andon Hestiantoro","email":"","orcid":"","institution":"University of Indonesia Faculty of Medicine: Universitas Indonesia Fakultas Kedokteran","correspondingAuthor":false,"prefix":"","firstName":"Andon","middleName":"","lastName":"Hestiantoro","suffix":""}],"badges":[],"createdAt":"2024-05-16 06:59:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4429040/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4429040/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58342222,"identity":"1293bc87-aa23-4320-ac02-b104bea98405","added_by":"auto","created_at":"2024-06-14 07:00:36","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":371278,"visible":true,"origin":"","legend":"","description":"","filename":"001MANUSCRIPTKANADISUMAPRAJA.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4429040/v1_covered_6be214c2-d153-42ef-a394-9a75c5193ea6.pdf"}],"financialInterests":"","formattedTitle":"Endometriosis Care in the Indonesian Healthcare Referral System: Evaluating Diagnostic Delays and Therapeutic Approaches","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"middle-east-fertility-society-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"mefj","sideBox":"Learn more about [High Temperature Corrosion of Materials](https://www.springer.com/journal/43043)","snPcode":"43043","submissionUrl":"https://submission.nature.com/new-submission/43043/3","title":"Middle East Fertility Society Journal","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Endometriosis, Health Care Delivery, Health Services Accessibility, Insurance, Referral and Consultation","lastPublishedDoi":"10.21203/rs.3.rs-4429040/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4429040/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground\u003c/p\u003e\n\u003cp\u003eEndometriosis, a prevalent gynecological disorder, poses significant challenges in diagnosis and treatment, often leading to delayed care and compromised quality of life. With the implementation of the Indonesian National Health Insurance, understanding the diagnostic and treatment patterns for endometriosis becomes crucial in this evolving healthcare framework. This study aims to evaluate prehospital treatment patterns of endometriosis patients before referral to tertiary healthcare within the Indonesian National Health Insurance era.\u003c/p\u003e\n\u003cp\u003eMethods\u003c/p\u003e\n\u003cp\u003eA descriptive study involving 30 female patients diagnosed with endometriosis was conducted at a tertiary hospital in Jakarta, Indonesia. Data collection included structured interviews and retrieval of secondary data from health records. Descriptive analysis was performed using SPSS software.\u003c/p\u003e\n\u003cp\u003eResults\u003c/p\u003e\n\u003cp\u003eThe study revealed a mean age of 36.3 years among respondents, with diverse manifestations of endometriosis, including adenomyosis, cysts, and deep infiltrating endometriosis. Patients experienced symptoms for an average of 8.5 years before seeking tertiary care, with significant reliance on pharmacological interventions such as NSAIDs and hormonal therapies. Surgical interventions, primarily cystectomy, were also common, with 40% of respondents undergoing surgery. The study highlighted care coordination challenges and delays in diagnosis and treatment initiation.\u003c/p\u003e\n\u003cp\u003eConclusions\u003c/p\u003e\n\u003cp\u003eThe study reveals significant delays in diagnosing and treating endometriosis under the Indonesian National Health Insurance system. Improved awareness, education, and multidisciplinary approaches are essential to enhance early detection and optimize patient outcomes globally and within the Indonesian National Health Insurance framework.\u003c/p\u003e","manuscriptTitle":"Endometriosis Care in the Indonesian Healthcare Referral System: Evaluating Diagnostic Delays and Therapeutic Approaches","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-14 06:52:30","doi":"10.21203/rs.3.rs-4429040/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Reject after peer review","date":"2024-07-30T06:12:49+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2024-06-03T05:55:24+00:00","index":0,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-06-02T23:07:57+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"Middle East Fertility Society Journal","date":"2024-05-30T18:17:11+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-17T01:59:39+00:00","index":"","fulltext":""},{"type":"submitted","content":"Middle East Fertility Society Journal","date":"2024-05-16T02:58:24+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"middle-east-fertility-society-journal","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"mefj","sideBox":"Learn more about [High Temperature Corrosion of Materials](https://www.springer.com/journal/43043)","snPcode":"43043","submissionUrl":"https://submission.nature.com/new-submission/43043/3","title":"Middle East Fertility Society Journal","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Open","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3d74e537-c35d-4503-8313-fc618e745d12","owner":[],"postedDate":"June 14th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2024-06-14T06:52:30+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-14 06:52:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4429040","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4429040","identity":"rs-4429040","version":["v1"]},"buildId":"B-jG_2CBjPDmsCi4Wdhf-","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}