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The purpose of this study is to evaluate the determinants of health outcomes of dialysis patients, while specifically focusing on the role of dialysis process measures and dialysis practice characteristics. The dialysis industry is facing a major transition from a volume-based health care system to a value-based cost-efficient care model, in the USA. Under the bundled Prospective Payment System, the treatment-based payment model is subject to meeting quality thresholds as defined by clinical process measures including dialysis adequacy and anemia management. Few studies have focused on studying these two processes and their association with the quality of patient health outcomes.

In this study, the authors focus on identifying the determinants of patient health outcomes among freestanding dialysis clinics, using a large cross-sectional data set of 4,571 dialysis clinics in the USA. The authors use econometric analyses to estimate the association between dialysis facility characteristics and practice patterns and their association with dialysis process measures and hospitalization risk.

The authors find that reusing dialyzers and increasing the number of dialysis stations is associated with higher levels of clinical quality. This research indicates that deploying more nurses on-site allows patients to avail adequate dialysis, while increasing the supply of physicians can hurt anemia control process. In addition, the authors report that offering peritoneal dialysis and late night shifts are not beneficial practices in terms of their impact on the hospitalization risk.

While early studies of dialysis care mainly focused on the associations between practice patterns and patient outcomes, this research reveals the underlying mechanisms of these relationships by exploring the mediation effects of clinical dialysis processes on patient outcomes. The results indicate that dialysis process measures mediate the impact of the operational characteristics of dialysis centers on patient hospitalization rates.

This study offers several managerial insights for owners and operators of dialysis clinics with respect to the association between managerial and clinical practices that they deploy within dialysis clinics and their impact on clinical quality measures as well as hospitalization risk of patients. Managers can draw on this study to optimize staffing levels in their dialysis clinics, and implement innovative clinical practices.

Considering the growth in healthcare expenditures in developing and developed countries, and specifically for costly diagnoses such as dialyses, this study offers several insights related to the inter-relationships between dialysis practice patterns and their clinical quality measures.

This study makes several major contributions. First, the authors address the extant gap in the literature on the relationships between dialysis facility and practice characteristics and clinical outcomes, while specifically highlighting the role of clinical process measures as antecedents of patient hospitalization ratio, a key metric used to measure performance of dialysis clinics. Second, this study sheds light on the underlying mechanisms that serve as enablers of the dialysis adequacy and anemia management. To the best of the authors’ knowledge, this is the first study to explore these relationships in the dialysis industry. The authors’ approach provides a new direction for future studies to explore the pathways that may impact clinical quality measures in the delivery of dialysis services.

The purpose of this paper is to investigate the relative influences of technical and functional quality levels of service quality and patient satisfaction. In this context, the healthcare service quality and the factors affecting customer satisfaction were evaluated using the grey relational analysis (GRA) method.

This is a survey-based study which involves 15 patients in a dialysis center, so the GRA is applied to clarify the uncertainty on service quality level with a limited number of patients without any statistical distribution. In order to reveal whether service quality and customer satisfaction are two different structures, a GRA model is built with ten different quality factors.

Results show that each quality factor has a different effect on the quality of service. Another important finding is that service quality and customer satisfaction are different structures for customers.

The results enable healthcare managers to understand the importance of patient care and the importance of service quality if they want to facilitate their use of their expectations in related factors.

The study is the first in terms of the application of GRA models in a private health institution operating in Turkey. Successful implementation of the GRA method allows a reasonable decision to be made with a limited number of data at hand. It is considered that the method can be used successfully in other health institutions in the Turkish Health System.

Advances in recombinant drug technology will impose pressure for swift action by decision‐makers who may be required to operate on the basis of very limited information. This paper is the by‐product of a recently initiated North Western Regional Health Authority interim procedure designed to give swift consideration to innovations, to provide additional information for decision‐makers and to permit both clinicians and decision‐makers to combine in ensuring that greater rationality is applied to the introduction of drug innovations than might otherwise be the case. It is envisaged that this procedure will be of equal value in other areas where new medicines may have major revenue consequences.

Recently the revival of the institution of waqf took a movable form especially in terms of the creation of cash waqf which found its ways as one of the financial institutions financing different goods and services in the different countries. In an attempt to enrich the literature on this area, this study is an extension to the authors' work, focusing mainly on the different goods and services provided by different cash waqf schemes in Muslim and Muslim minority countries without depending on the government to provide their needs. The paper aims to discuss these issues.

This study uses data collected from primary sources including text from the Hadith, while data collected from secondary sources include books, articles, journals besides web sites and e-books.

The findings show the potential of cash waqf in financing not only religious areas but also financing different goods and services needed globally, such as education, health, social care and commercial activates, basic infrastructures, besides opening jobs for the majority of people.

The expected outcome of this research is to open the door wider for more researchers to explore the potential of cash waqf as one of the instruments to finance all sectors in Muslim and Muslim minority countries without exhausting government budget.

A revitalization of an old Islamic financial product to meet the different needs.

This is the eighth article on science, technology and medicine (STM) databases in a continuing series of articles summarising and commenting on new database products. Two companion articles will appear in the next two issues of this journal, one covering social sciences, humanities, news and general (SSH) (Online & CDROM Review, vol. 20, no. 5) and the other covering business and law (BSL) (Online & CDROM Review, vol. 20, no. 6). These articles are based on the newly appearing database products in the Gale Directory of Databases. The Gale Directory of Databases (GDD) was created in January 1993 by merging Computer‐Readable Databases: A Directory and Data Sourcebook (CRD) together with the Directory of Online Databases (DOD) and the Directory of Portable Databases (DPD).

As the rise in expenditures will be even faster when the baby-boom generation soon reaches healthcare-dependent ages, healthcare providers are facing cost management decision of achieving superior performance. Taiwan provides a unique environment that the dialysis service providers face only one medical buyer. The purpose of this paper is to discuss cost factors of dialysis facilities.

This study provides a comprehensive analysis of factors influencing the dialysis costs using the data collected from a large renal clinic chain at Taiwan. The multiple linear regression analysis is employed to examine the factors influencing dialysis costs. The research sample composed of 1,255 patients is collected from 16 dialysis centers in Taiwan.

The results indicate that the treatment costs of dialysis are influenced by managerial factors including capacity utilization rate (CUR), the percentage of shares held by the owners and the geographical location of clinics (LC). The findings assist renal clinics to identify the parts critical to the cost control. Our results indicate that medical variable costs for performing the dialysis treatments are significantly influenced by such managerial factors as CUR, the percentage of owners’ shares holding and LC.

By identifying a comprehensive set of costs drivers for dialysis services, this study provides useful information for both health providers and policy makers. In specific, the result assists these providers to consider the utilization of better mechanisms/instruments to control costs by increasing the operational efficiency and achieving the economies of scale.

This paper contributes to exploring costs drivers that are generally absent from the extant literature. The result suggests that the regulators should be aware that the dialysis providers may reject costly patients. Hence, to establish the appropriate monitoring mechanisms to prevent such incidence is important. Finally, many other countries in addition to Taiwan also have a similar practice as national health insurances or services (e.g. Medicare in the USA or National Health Service in the UK). Those health systems may all face a similar cost control issues for handling end-stage renal disease patients. The analysis can help health systems worldwide to better design the reimbursement rates to account for the differences existed in dealing with the dialysis treatment costs.

According to the principle of equivalence of care, health care in prison has to be of the same standard and quality as in the general population. This study aims to determine the geographic accessibility of dialysis services for older prisoners and the older general population in Switzerland and whether accessibility and availability of dialysis care are equivalent.

Spatial accessibility analysis incorporated four different data types: population data, administrative data, street network data and addresses of prisons and hemodialysis services.

Analysis revealed that the average travel time to the nearest dialysis service was better for prisoners (11.5 min) than for the general population (14.8 min). However, dialysis service for prisoners is hampered by the necessary lead-time in correctional settings, which, ultimately, leads to longer overall access times (36.5 min). Accordingly, the equivalence of dialysis care for older Swiss prisoners is not entirely respected for availability and accessibility.

The strength of the study lies in the combination of ethical principles and the highly tangible results of a spatial accessibility analysis. The ethics-driven empirical analysis provides arguments for policy-makers to review the current practices.

Intermountain Health Care, a system of 24 acute care, not‐for‐profit hospitals in Utah, Idaho and Wyoming, USA, is focused on with regard to its use of computers to integrate the various clinical, financial and patient‐oriented databases in order to assess variance in terms of quality, utilisation and efficiency (QUE). Examples are given of the studies carried out, and a QUE study on the management of uncomplicated transurethral prostatectomies is detailed. The benefits gained through the use of the system are described in the pharmacy system, in the monitoring of infectious diseases and in the charting of respiratory care.

The purpose of this paper is to explore the possibilities and the growth prospects of medical tourism in Greece, while particularly focusing on the dialysis process. Patients with end-stage renal failure have the right to any treatment deemed necessary during their journey to another city or country away from the place where their treatment normally takes place.

The survey has been conducted among 193 kidney disease patients that underwent extra-renal dialysis in two public and three private artificial kidney units in Thessaloniki. The study population consists of patients with end-stage chronic renal failure (CRF) that undergo dialysis. For the purpose of this study, quantitative research was carried out via a structured and anonymous questionnaire. The design and structure of the study were based upon questionnaires from two relevant questionnaires. The questionnaires were modified appropriately to respond to the subject in question. Finally, for the analysis of the data, the SPSS software has been used.

One of the most obvious results is that patients on dialysis treatment have limited both the frequency and the duration of their vacation. The 8.3% of patients that did not use to travel increased to 37.8%, whereas only 22.3% continue to travel 2–4 times a year. Patients that keep on going on vacation frequently claim that a break from the daily routine improves their quality of life. Most of the participants (up to 36.3%) claim they feel healthier, while 34.2% stated they experience a normal life when they escape their everyday life and travel far from home. The 69.9% claim that Greece has the potentials to be a popular medical tourism destination. However, a well-structured and government-financed assistance programme is absent. The processing of data has revealed a positive correlation between age and tourism behaviour. Additionally, according to the research results, younger patients tend to be better informed regarding medical tourism in comparison with older ones.

Considering the patients to be potential travellers facilitates the development, realization and promotion of medical tourism.

This study attempts to investigate, for the first time, the tourism behaviour of chronic kidney disease patients. The study highlights a sensitive issue, patients’ right to treatment without geographical or distance-related obstacles.

The quality of haemodialysis process is a prime concern in renal care. This study, carried out at one of the leading Hospitals in Central India, providing kidney care and dialysis, aims to identify areas in the haemodialysis unit needing special attention, to improve process quality and ensure better patient welfare.

The failure mode and effects analysis (FMEA) approach included: deciding haemodialysis process requirements, identifying potential causes of process failure and quantifying associated risk with every cause. Suitable actions were then implemented to reduce the occurrence and improving the controls, thereby reducing risk. The study used primary data generated and monitored over the period: July‐December 2008.

Adopting proper checklists for work monitoring, providing training to enhance patient and staff awareness; led to reduced process errors, mitigating overall risks, eventually resulting in effective patient care.

The quantification of risk associated with every likely failure is subjective.

The findings have a great significance in relation to kidney patients' welfare. The process areas which may get compromised are highlighted so that they get due attention. Error proofing makes the process “robust”, reducing its vulnerability.

This study provides a microscopic error proofing approach to haemodialysis process using a proven engineering tool, FMEA, ensuring quality improvement. This approach can also be extended to cover other hospital activities.