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View all search resultsJKN revamp seeks to streamline hospital referrals
The government has unveiled a new hospital referral system for the National Health Insurance (JKN) program with the aim of reducing costs and shortening treatment times.
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Patients wait for medicines at a pharmacy at Yarsi General Hospital in Pontianak, West Kalimantan, on May 14, 2024. (Antara/Jessica Wuysang)
T
he government has unveiled a new hospital referral system for the National Health Insurance (JKN) program with the aim of reducing costs and shortening treatment times, although concerns are mounting that its success will depend on first addressing quality gaps among primary healthcare facilities.
Speaking in a press conference on Friday, the Health Ministry’s director for clinical services Obrin Parulian said the competency-based referral system was expected to improve access to high quality and affordable health care for JKN policyholders.
It seeks to do so by introducing a new grading system that evaluates hospitals across 24 medical departments, with each cluster ranked as one of four tiers based on the quality and availability of medical personnel, infrastructure and equipment.
This marks a significant change from the current system, which classifies hospitals into classes A to D solely based on bed capacity rather than the quality of service they provide.
“Under the new framework, a hospital may receive the highest rank for cardiovascular care if it can manage even the most complex heart cases, but its services for eye care may not be rated at the same level,” Obrin said.
With the new grading system, he said, primary care facilities, such as community health centers (Puskesmas), will be able to send patients directly to any hospitals with appropriate expertise to treat their condition.
By contrast, under the current system, a Puskesmas can refer patients only to a class D or C hospital, even when they are clearly in need of advanced care. From there, patients may be transferred to a class B facility and ultimately to a class A hospital, resulting in as many as three transfers.
