Ervana Trikarinaputri, Jakarta – Indonesia's Ministry of Health has revealed that only 24 percent of hospitals in the country meet the national standards for facilities, infrastructure, and medical equipment.
Director General of Health Services Azhar Jaya said a hospital's facilities are considered adequate if they reach at least 80 percent of national standard completeness.
"This means that many hospitals still lack the necessary facilities and infrastructure," Azhar said during a National Health Insurance (JKN) Working Committee meeting at the House of Representatives in Senayan, Jakarta, on Thursday, November 13, 2025.
"Out of 3,269 hospitals, only 24 percent have achieved more than 80 percent completeness."
Most government hospitals fall short
Indonesia currently has 1,221 government hospitals, consisting of 258 under the central government, 800 operated by local governments, and 153 run by provincial administrations. In addition, there are 2,048 private hospitals nationwide.
Among the government-run facilities, Azhar said 946 hospitals still fall short of the required standards.
"Only 275 government hospitals have facilities and infrastructure above 80 percent," he noted.
"This is a serious concern for us, and we are committed to improving hospital facilities and infrastructure across the country."
Referral system to shift toward competency-based services
Azhar also announced that the Ministry of Health will soon introduce a new referral system aimed at improving patient access to appropriate medical services.
The current tiered referral structure, which requires patients to move from primary health centers (Puskesmas) to class D, C, B, and then class A hospitals, will be replaced by a competency-based referral mechanism.
"In the future, patients will be referred based on their medical needs and the hospital's level of competency, not its class," Azhar explained.
"For example, a patient could be referred directly from a primary health center to an intermediate or main hospital if the condition requires it."
Under this new structure, hospitals will be categorized into basic, intermediate, main, and comprehensive service levels, depending on their capacity and available medical expertise.
"This way, referrals will be based on the patient's specific medical condition and disease severity," Azhar said. "It will ensure that patients receive faster, more effective care."
Aiming for efficiency and cost savings
Azhar emphasized that the competency-based referral system is designed not only to streamline patient care but also to reduce financial burdens on both patients and healthcare providers.
"If a patient is referred to a hospital, the entire treatment process should be completed there," he said.
"For BPJS [Indonesia's national health insurance] participants, this means they only need to pay at one hospital and won't be charged again at another facility."
He added, "Once the referral is made, the hospital receiving the patient must handle all aspects of care. That's what we mean by a competency-based referral system."