Exploring general practitioners' perceptions about the primary care gatekeeper role in Indonesia.

Area of Science:

• Healthcare policy and management
• Primary care
• Health services research

Background:

• The National Health Insurance (NHI) in Indonesia relies on primary care gatekeeping for equitable healthcare access.
• General Practitioners (GPs) are crucial for effective gatekeeping, yet their perceptions are under-documented.

Purpose of the Study:

• To describe Indonesian GPs' self-perceived knowledge, attitudes, and performance regarding their gatekeeper role.
• To explore factors associated with GPs' gatekeeper role perceptions and performance.

Main Methods:

• A cross-sectional study surveyed 73 GPs from 75 primary care facilities in Banyumas district, Indonesia.
• A questionnaire assessed GPs' knowledge, attitudes, and performance related to the gatekeeper role.
• Generalized linear models analyzed personal and facility characteristics associated with gatekeeper role perceptions.

Main Results:

• GPs reported high knowledge and performance but lower positive attitudes towards the gatekeeper role.
• Attitude scores were influenced by employment status and facility location (rural/urban).
• Performance scores were associated with employment type (full/part-time) and facility type, with positive attitudes linked to better performance.

Conclusions:

• Indonesian GPs possess adequate knowledge and performance for their gatekeeper function, but attitudes require enhancement.
• Contextual factors like facility location and type significantly impact gatekeeper role attitudes and performance.
• Addressing contextual issues and improving practice standards are vital for strengthening primary care gatekeeping in Indonesia.