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The purpose of this study is to examine different types of primary healthcare utilization and its influencing factors among the elderly in Indonesia.

Data were obtained from the 5th Indonesian Family Life Survey, a longitudinal database of demography and health information using multistage stratified sampling of households. Older adults aged at least 60 years were sampled; proxy respondents and incomplete data were excluded from the study.

Most of the elderly preferred to visit nurse/midwives practitioner (NP), followed by the community health centers (CHC). Those who lived outside of the Java region were more likely to visit NP; moreover, those without formal education and lived in the rural area were more likely to use CHC. Education level, region and chronic conditions were significant predicting factors for almost all types of primary healthcare use.

Indonesia is moving towards an aged society in the coming decades. However, there are significant barriers to access almost all types of primary health care by the elderly in Indonesia. This shows the possibility of health care inequality for the elderly population. This study provides evidence of the various types of primary healthcare use by the elderly and its influencing factors. It hopes policymakers can use the data to develop an effective strategy to enhance the quality of primary healthcare services provides to the elderly population.

Indonesian nurses fulfill vital functions in the health system and are often the only human resource for health not only in remote and poor rural areas but also in urban areas. Nurses, as a part of primary care providers, require an adequately trained to contribute to the better primary care system.

The study aimed to develop a reliable and valid instrument that could be used to assess the age-friendly Public Health Center Satisfaction (APHCS) among older people.

A cross-sectional study was performed to assess the psychometric properties of the scale. The study was conducted in Manado City, Indonesia, from August to November of 2019 using stratified random sampling. A review of the literature and content analysis identified subscales and items to be included in the instrument. The 268 participants aged = 60 years were completed for psychometric evaluation with a response rate of 83.8%. Data were analyzed with descriptive statistics, Exploratory Factor Analysis (EFA), Cronbach's Alpha, t-test, one-way ANOVA, and Person/Spearmen correlations.

The final scale consists of a three-factor structure with 16 items, which were accounted for 68.99% of the total variation in response. The Cronbach's alpha of the total APHCS was 0.88, which indicated the high reliability and acceptance of the instrument. Also, the concurrent validity was demonstrated by the significant differences in mean and associations among the APHCS scale, the age-friendly Public Health Center (PHCC) utilization, and individual variables, with r ranging from −0.13 to 0.30 (p < 0.05).

Older people are more likely to use PHCCs than others, and they have higher expectations about health services. This study has highlighted the need for action on the quality of healthcare by providers and national authorities. High-quality primary healthcare that sees clients as partners, considering the needs and capacities of elderly clients should be provided as standard. The APHCS scale can enhance our understanding of elderly satisfaction toward the age-friendly PHCC program. Also, the instrument can be used for monitoring and measuring institutions, which is a basis for policymakers to improve and develop the age-friendly PHCC program.

The APHCS scale is a valid and reliable instrument for getting information about the satisfaction of the elderly toward the age-friendly PHCC program.