Aging and Long-Term Care in Indonesia's National Health Insurance (JKN)

Executive summary

This report describes how older people in Indonesia, aged 60 and over, use the National Health Insurance scheme (JKN), and what their long-term-care needs look like, using the BPJS Kesehatan Sample Data for 2015 to 2024. It covers disease burden, the point of first contact with the health system, primary-care and hospital use, geriatric syndromes, multimorbidity, the cost of care, and equity across regions and membership segments.

All population figures are survey-weighted national projections from the sample and describe the population that is served by JKN, not the true prevalence in the whole population. Indicators are mapped to international frameworks for healthy aging and long-term care (WHO Healthy Ageing and ICOPE, OECD Long-Term Care), with population benchmarks from Statistics Indonesia (BPS) and the 2023 Indonesia Health Survey.

Questions this report answers

• How many older people use JKN services, and through which door do they enter the system?
• How large is the burden of multimorbidity and geriatric syndromes among older people?
• How much does hospital care for older people cost, and how concentrated is that spending?
• Is access to care equitable across regions and membership segments?

Key findings

• Most older people enter the system through primary care (about 79 percent of first contacts via FKTP), but the share entering directly through hospital inpatient admission rises steeply with age, from about 7 percent among the pre-elderly to about 21 percent at age 80 and over.
• Among older people served, hypertension is recorded in about 47 percent and diabetes in about 19 percent, and roughly 30 percent carry two or more chronic conditions, with cardiometabolic combinations dominating.
• About 14 percent of older-adult hospital admissions are for ambulatory-care-sensitive conditions that good primary care could help prevent.
• Hospital (FKRTL) spending on older people reached about Rp 37 trillion in 2024, around Rp 221 trillion cumulatively over 2015 to 2024, and spending is highly concentrated, with the top 10 percent of patients accounting for about half of the total.
• The rate of older people served per 1,000 elderly members, and spending per patient, vary across provinces and membership segments, pointing to uneven access that is relevant for strengthening geriatric and long-term care.