Patients access primary care practitioners through the Puskesmas. There is a maximum ratio of 5,000 patients per primary care practitioner to encourage quality of care. Furthermore, primary care practitioners have been trained on ‘standard care competencies for the most common 144 diagnoses and 11 medical conditions’ by the Indonesian Medical Council. Where patients present with other conditions, they receive a referral to a specialist based in a lower-class hospital. Only from there, patients can be referred to higher class hospitals (Agustina et al., 2019, p.89).

Lack of knowledge on how to access services has been reported among subsidised members of the National Health Insurance System (NHIS) (Agustina et al., 2019, p.94).

References:

Agustina, R., Dartanto, T., Sitompul, R., Susiloretni, K. A., Suparmi, Achadi, E. L., Taher, A., Wirawan, F., Sungkar, S., Sudarmono, P., Shankar, A. H., Thabrany, H., Susiloretni, K. A., Soewondo, P., Ahmad, S. A., Kurniawan, M., Hidayat, B., Pardede, D., Mundiharno, … Khusun, H. (2019). Universal health coverage in Indonesia: concept, progress, and challenges. The Lancet, 393(10166), 75–102. https://doi.org/10.1016/S0140-6736(18)31647-7