Ambulatory Care Sensitive Conditions for Indonesia (INA-ACSC)

Executive summary

Ambulatory Care Sensitive Conditions are conditions that primary care can prevent or manage well enough to avoid hospitalisation, and internationally they serve as a primary-care performance indicator. Indonesia has lacked a national list reflecting local epidemiology and JKN service patterns. This brief builds an evidence-based INA-ACSC list by integrating international literature, BPJS inpatient claims, national guidelines, and clinical consensus, showing that preventability is a spectrum shaped by local disease patterns and health-system readiness.

Questions this report answers

• Which conditions in Indonesia are genuinely preventable through stronger primary care?
• How should an Indonesia-specific ACSC list differ from the international ones?
• Where can health-system strengthening cut avoidable hospitalisation and cost the most?

Key findings

• Most high-inpatient-burden conditions in BPJS claims classify as True or Conditional ACSC, including chronic cardiovascular disease, diabetes complications, respiratory disease, and common infections.
• Tropical infections relevant to Indonesia, such as dengue, typhoid, and intestinal infections, are absent from international ACSC lists and require local adaptation.
• Some conditions treated as ACSC globally are not classified as such in Indonesia because of limits in primary-care diagnostic, drug, and specialist capacity.
• A new Conditional ACSC category captures conditions that are preventable in theory but depend on health-system readiness, marking the areas most responsive to system strengthening.
• The work was a winner of the BPJS Open Call for Research 2025.