Indonesia Overhauls Healthcare Referral System to Streamline Patient Care
Indonesia is poised to significantly reform its healthcare referral system, aiming to reduce patient wait times, improve recovery rates, and lower costs by eliminating unnecessary hospital transfers. The changes, spearheaded by Health Minister Budi Gunadi Sadikin, shift the focus from a tiered hospital classification system (A, B, C, and D) to one based on specialized competency classification.
The current system, often criticized for its inefficiencies, requires patients to navigate multiple hospital levels depending on the complexity of their condition. This can lead to delays in diagnosis and treatment, as well as increased financial burdens. The new regulations represent the second pillar of a broader health transformation initiative focused on improving service delivery within hospitals.
Under the revised system, hospitals will be categorized as “plenary,” “main,” “intermediate,” or “basic” based on their expertise in specific medical fields. A hospital might be considered highly proficient in cardiology, for example, but only “main” or “basic” in ophthalmology. This allows first-level health facilities (FKTP) to directly refer patients to hospitals with the appropriate specialization for their specific needs.
“If the primary [hospital] is full, or the treatment is incomplete, then it will be sent to plenary,” explained a senior official at the Indonesian Ministry of Health during a press conference on Friday, November 21, 2025. “So we will make a maximum of one hospital change.”
The Ministry of Health has been actively soliciting feedback from professional organizations and stakeholders since May to ensure a smooth transition. According to the official, the standards were developed based on this collaborative input. The goal is to launch the new system in January 2026.
To illustrate the benefits of the new approach, the Ministry presented a case study involving a 42-year-old woman experiencing chronic lower abdominal pain and shortness of breath. Under the current system, she would initially be referred to a basic or type D/C hospital. During evaluation, a potential ovarian mass was discovered, but the facility lacked the necessary gynecological oncology resources. This necessitated a referral to a class B hospital, which then determined the need for specialized treatment and chemotherapy only available at a class A hospital – resulting in multiple transfers and significant delays.
The new competency-based system would bypass this protracted process. FKTPs will be empowered to directly refer patients to hospitals equipped to handle their specific conditions, at least at the primary level, with a streamlined escalation path to plenary hospitals if necessary. “So the transfer is only one time,” the official stressed.
The implementation of this new system promises a more efficient and patient-centered healthcare experience for Indonesians. The Ministry of Health anticipates that these changes will not only improve clinical outcomes but also reduce the overall cost of care by minimizing unnecessary administrative burdens and hospital transfers.
