Tipe RS

01Regulatory Background and Paradigm Shift

The classification of hospitals in Indonesia was historically governed by Permenkes 340/MENKES/PER/III/2010 and later by PP 47/2021, which classified each hospital as a single entity into one of four tiers: Tipe A, B, C, or D. This framework grouped hospitals based on their overall facilities and service capabilities.

In 2023, the Indonesian government enacted UU No. 17 Tahun 2023 tentang Kesehatan (the omnibus Health Law), which mandated a new approach. Permenkes 6/2026 (Pasal 12) formally eliminates the old class system and replaces it with classification based on service capability per service group, using the tiers: Paripurna, Utama, Madya, and Dasar.

The core concept to grasp here is the paradigm shift. Under the old system, a hospital received a single label. Under the new system, a hospital can hold Paripurna classification for surgical services but Madya for internal medicine. The assessment is now service-based and capability-based, no longer determined solely by bed count or the presence of certain specialists.

This also changes the referral system. The old tiered referral (FKTP to Tipe D to C to B to A) under PMK 1/2012 is replaced by competency-based referral (PMK 16/2024), where patients are directed to the nearest hospital with the appropriate capability level for their condition.

02The Old Classification System (Tipe A, B, C, D)

Although the old system is being phased out, exam vignettes during the transition period may still reference it. You must know both.

The 4 Basic Specialists (Spesialis Dasar) are the most tested detail for the old system:

1. Internal Medicine (Sp.PD)

2. Surgery (Sp.B)

3. Pediatrics (Sp.A)

4. Obstetrics and Gynecology (Sp.OG)

A Tipe C hospital requires at minimum all 4 basic specialists and 4 supporting medical specialists. A Tipe D hospital requires at minimum 2 basic specialists.

A Tipe A hospital must have at minimum 4 basic specialists, 5 supporting specialists, 12 other medical specialists, and 13 subspecialists.

03The New Classification System (Paripurna, Utama, Madya, Dasar)

Legal Foundation

The new system rests on three pillars of legislation:

Classification Tiers

Starting in 2025, hospitals are classified based on their level of capability in delivering services: Rumah Sakit Dasar provides basic health services; Rumah Sakit Madya has basic specialist services and some advanced support; Rumah Sakit Utama has specialist and partial subspecialist services with more advanced facilities including advanced ICU and complex operating rooms.

The 24 Service Groups (Kelompok Layanan)

Hospital classification is mapped across 24 service groups. Each service group is independently assessed and assigned a tier. The full list:

For each of these 24 groups, a hospital receives a classification (Dasar, Madya, Utama, or Paripurna) based on three pillars: (a) human resources/competency, (b) facilities and infrastructure, and (c) medical equipment.

Worked Example: Cardiovascular Service Group

The Kemenkes presentation from June 2025 provides a concrete example of how this looks for Cardiovascular Services (Service Group #2).

a. Human Resources by Tier

b. Facilities by Tier

c. Equipment by Tier

04Minimum Hospital Service Requirements

According to PP 28/2024 Pasal 821, every hospital must provide at minimum 12 categories of health services. These are not negotiable regardless of classification tier:

Hospital Bed Requirements under Permenkes 6/2026

PMDN (domestic investment) hospitals must have at least 50 inpatient beds and provide a minimum of 2 services at Dasar classification. PMA (foreign investment) hospitals must have at least 50 beds with 1 Paripurna-level service, or 200 beds with at least 2 Paripurna-level services.

05Comparison: Old vs. New System

This new approach is considered to emphasize quality and actual service capability rather than merely institutional capacity such as bed count.

06Distractors

07Traps and High-Yield Pearls

The most common way students get questions about hospital classification wrong is by applying the old Tipe A/B/C/D framework to new-regulation scenarios. If the question stem references UU 17/2023, PP 28/2024, or Permenkes 6/2026, you must shift to the new paradigm of Paripurna/Utama/Madya/Dasar.

A second frequent error is confusing bed count requirements across tiers. Under the old system, the numbers to remember are: D = 50, C = 100, B = 200, A = 400. Under the new system, minimum beds for PMDN is 50 regardless of classification tier, but the classification tier for each service depends on capability, not bed count.

A third trap involves the 4 spesialis dasar. Students commonly mix up Tipe C and Tipe D requirements. The mnemonic is: Tipe D = "Dua" (two basic specialists), Tipe C = "Complete" (all four basic specialists).

Finally, understand that the new referral system eliminates strict tiered escalation. A vignette describing a patient with an acute cardiovascular emergency should lead you to the nearest hospital with the appropriate cardiovascular service capability (for example, Madya or higher, which has a cathlab), not simply "the next class up" from the patient's current facility.

The core competency being tested here is your understanding of how the Indonesian health system organizes hospital care and your ability to apply the correct regulatory framework depending on the context of the vignette. When in doubt, check the date or the regulation cited in the question stem to determine which system they are asking about.