Explaining Indonesian Patients’ Experiences About Changes in the Hemodialysis Cost System

Aim: To explore the experience of haemodialysis patients in Indonesia over a decade, amidst changes in the cost system in hospitals. Since its implementation, the Universal Health Coverage (UHC) policy has significantly influenced haemodialysis services in hospitals, affecting patients' experiences. Material and Methods: Qualitative study. Twenty-two haemodialysis patients selected by snowball sampling from the Indonesian Dialysis Patient Community (Komunitas Pasien Cuci Darah Indonesia) participated. Data were collected through interviews, transcribed and analysed thematically, and psychological methods based on patients' experiences were used. Results: identified three main themes (health coverage system, haemodialysis services, haemodialysis facilities) and ten sub-themes (complex monthly payment situation for care recipients, unexpected deactivation of payment status, outdated referral system requirements, payment system complications for care recipients, penalty for late payments, disparities in services between hospitals, insufficient coverage for certain services, accessibility problems with distant haemodialysis units, variations in types of haemodialysis equipment, and inadequate comfort in the family waiting room). Conclusions: The health insurance system needs to be improved to increase access, equity, affordability, efficiency, consistency and quality of haemodialysis services in Indonesian hospitals. Collaborative efforts by the government, health institutions and related parties are essential.