Factors Affecting Back Referral of Type 2 Diabetes Mellitus Patient of National Health Insurance Members from the Hospital to the Primary Care Physicians

Increased number of National Health insurance members with type 2 diabetes mellitus (DM) may have an impact of cost of health care. Since 2010,Social Security Agency on Health implemented the Chronic Disease Management Programme (Prolanis), especially for type 2 DM disease. However, back referral from internal medicine specialist to primary care physician was not well implemented. This study aims to identify perceptions of internal medicine specialist and patients affecting implementation of back referral for patients with type 2 DM from the hospital to primary care physicians. A qualitative study was employed, using in-depth interviews, observation and focus group discussions. In-depth interviews were conducted with eight internal medicine spesialists in one hospitals in Jakarta Selatan City and two primary care physicians. Focus group discussions were conducted with four groups of patients with type 2 DM, and observation was made to describe the working environment at thehospital.