Table 1.
Profile of BPJS-K participants who had transactions in primary care providers and secondary care providers (Weighted data).
| Demographics | Attribute | Number of Unique Participants in Participants' Master File | Number of Unique Participants in Primary Care Providers' File | Number of Unique Participants in Secondary Care Providers' File | All Paired Referral Data | Paired Referral Data with Non-Malignant Disease | Paired Referral Data with Malignant Disease |
|---|---|---|---|---|---|---|---|
| Gender | Male | 98,144,376 | 15,434,764 | 8,833,764 | 1,542,974 | 1,536,506 | 12,703 |
| Female | 93,319,318 | 19,603,265 | 11,301,932 | 2,066,805 | 2,054,656 | 23,285 | |
| Undefined | 74 | 0 | 0 | 0 | 0 | 0 | |
| Age | 0–14 years old | 36,254,917 | 7,336,302 | 1,311,013 | 442,159 | 441,165 | 1,657 |
| 15–29 years old | 48,317,065 | 7,275,912 | 3,834,998 | 617,299 | 616,024 | 3,379 | |
| 30–44 years old | 44,021,372 | 8,719,266 | 1,413,756 | 884,984 | 880,951 | 7,166 | |
| 45–59 years old | 29,643,364 | 6,115,406 | 4,856,276 | 858,696 | 851,859 | 13,303 | |
| ≥ 60 years old | 33,227,050 | 5,591,143 | 8,719,653 | 806,641 | 801,163 | 10,483 | |
| Marital Status | Single | 57,328,634 | 9,196,292 | 6,443,902 | 981,772 | 979,062 | 6,037 |
| Married | 55,402,399 | 12,370,427 | 9,415,921 | 2,193,344 | 2,181,330 | 24,231 | |
| Divorce | 2,605,197 | 569,497 | 741,439 | 134,303 | 132,674 | 2,594 | |
| Undefined | 76,127,538 | 12,901,813 | 3,534,434 | 300,360 | 298,096 | 3,126 | |
| Family Status | Single | 32,835,914 | 4,241,230 | 4,197,232 | 566,503 | 561,261 | 8,562 |
| With spouse | 6,963,098 | 1,801,998 | 1,980,799 | 370,886 | 367,452 | 8,026 | |
| With more than 1 spouses | 128,824 | 29,815 | 34,767 | 7,044 | 7,017 | 27 | |
| With spouse and 1 child | 9,845,981 | 3,581,704 | 2,811,080 | 531,262 | 529,443 | 6,219 | |
| With spouse and 2 children | 9,714,167 | 4,024,242 | 2,965,767 | 686,797 | 684,446 | 5,638 | |
| With spouse and more than 2 children | 6,454,017 | 2,697,972 | 1,882,343 | 397,150 | 396,083 | 2,583 | |
| With more than 1 spouses and more than 2 children | 137,853 | 53,524 | 55,981 | 15,979 | 15,841 | 204 | |
| With all the family schemes above plus additional membership | 10,195,661 | 3,593,273 | 2,636,929 | 394,857 | 392,941 | 4,636 | |
| Segmentation of Participants Based on Source of NHI Funding | Non-Workers | 8,082,380 | 1,063,301 | 1,311,013 | 301,907 | 300,575 | 3,335 |
| PBI APBN | 85,296,490 | 13,493,572 | 3,834,998 | 328,376 | 325,293 | 4,479 | |
| PBI APBD | 16,974,491 | 1,906,285 | 1,413,756 | 107,311 | 106,078 | 1,427 | |
| PBPU | 21,803,708 | 4,204,272 | 4,856,276 | 878,725 | 871,459 | 14,558 | |
| PPU | 59,306,699 | 14,370,599 | 8,719,653 | 1,993,460 | 1,987,757 | 12,189 |
Source: Authors' Calculation from BPJS-K Data.