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The purpose of this paper is to describe how frequent attenders (FAs), divided into different profiles, use of primary care, emergency care and specialised medical care and which social services have been granted to them.

The present study utilises previous research of FAs and their identification of four profiles. The data were acquired from three data registries in Finland. Analysis of the FAs (n = 56) data was undertaken using descriptive statistics methods and qualitative analysis.

Patients with multiple problems used primary care, emergency care and specialized medical care frequently, and they had the highest number of appointments with doctors and nurses. Social services were required mostly social work. Visits made by patients with an impaired capacity caused by substance abuse were mainly targeted at appointments and mental health care services to a nurse in primary care. The required types of social services were often rehabilitative work experience. For mothers requiring support, the most frequently used services in primary were the child health and maternity clinic. The social services granted were mostly social work. Children and adolescents who are burdened by everyday concerns visits were mainly focused on primary to the child health and maternity clinic. Use of social services often entailed the supervision of contact sessions between parents and children’s.

The study confirmed that there is a need for increase knowledge of FAs. The service needs of FAs should be understood multi-dimensionally and the research results justify the individualised integration of social and health services for FAs.

The research results justify the individualised integration of social and health services for FAs.

This paper aims to set out the relationship between business process reengineering (BPR) and data warehouse (DW) and identify the advantages brought by the integration of DW technology in BPR projects.

This paper is primarily based on a case study which was conducted in a Tunisian hospital and allowed some lessons to be learned.

Introducing changes in the field of healthcare services has become a necessity to provide better satisfaction to patients and to offer faster services and of better quality. So, the BPR approach can be applied to introduce these changes and provide better satisfaction to recipients of services, i.e. the hospital patients. This study is based on a case study based on the BPR application for healthcare process in some services of Farhat Hached Hospital in Sousse, Tunisia. This case study has mainly contributed to a proposed DW for healthcare services.

The proposed DW and the new corresponding process have not yet been implemented in the real life of the considered services. The research work in this project allowed the provision of detailed and rational justifications for the information technology introduction in BPR applied in healthcare services and in particular to the implementation of the DW concept. In addition to the detailed justifications, the research paper provided the prerequisite for the success of the project as well as its technical specifications and appropriateness to the specifity to the local setting.

The lessons learned were related in one hand to the particularities of BPR projects using the DW technology and on the other hand to the advantages brought by the DW technologies in the BPR projects. The following questions are considered in this paper: what are the particularities of the BPR projects using the DW technology? What are the main contributions of the DW technology to BPR projects?

The purpose of this paper is to provide an overview of post-Soviet and demographic challenges faced by the government in Moldova that have posed as challenges to reform of the healthcare system. Since independence from the Soviet Union in 1991, Moldova has undergone significant challenges and reforms throughout the society. Healthcare has been no exception. Changes in family structures due to migration, a decreased birthrate, and an aging population have placed strain on the healthcare system which is working to both modernize and provide specialized care. Legislation has helped to streamline and reform the healthcare system but systemic challenges are still faced by at-risk populations including the elderly, women, and rural populations.

Information presented in this paper is based on a review of independent research, United Nations and government reports.

Findings show that progress has been made through legislative reform, new government programming, and most recently volunteer/nonprofit involvement in healthcare reform. Currently, the government is working to establish holistic patient centered care and to bridge the healthcare divide between rural and urban populations. Healthcare reforms include basic universal health care services and family support programming. Additionally, there has been a renewed emphasis on how environmental factors, like housing and nutrition, interact with health quality.

Moldova faces an increasing challenge of caring for elderly populations at the family and societal level due to the increased number of elderly, shifts in family structures, and international migration for employment. A discussion of the developing role of nonprofit and nongovernment organizations is included.

The purpose of this paper is to examine multivariate analysis of challenges faced by patrons of medical tourism in Lagos metropolis, Nigeria.

Systematic sampling technique was employed to select 15 specialized private hospitals and 14 Public hospitals in the study area, resulting to a sample size of 29 hospitals. Ten patrons were contacted in each of the selected hospitals; consequently, 290 patrons were sampled.

The major challenges faced across the selected hospitals in the study area as revealed by this study included time spent in transit to hospital (PKI=3.96 and Mean Dev.=0.77), payment procedure is quick and simple (PKI=3.86 and Mean Dev.=0.67), package pricing is not transparent (PKI=3.76 and Mean Dev. =0.57), hospital facilities and equipment are not easily accessible (PKI=3.63 and Mean Dev.=0.44), Doctors do not pay enough attention to patrons (PKI=3.61 and Mean Dev.=0.42), Doctors do not give adequate explanation of patrons condition (PKI=3.49 and Mean Dev.=0.30), High cost of treatments (PKI=3.32 and Mean Dev.=0.13). The result of multiple regression analysis that produced (R²=0.933, F=296.080, p=0.000) meaning that challenges faced by patrons explain 99.3 percent variation of their destination choice.

The study revealed that challenges face by patrons determine their destination choice.

The purpose of this paper is to reduce the research gap in private sector participation in the Danish and German health systems, where empirical evidence is still very scarce compared with the impressive accumulation of similar literature in Anglo-Saxon countries.

Based on the findings of two case studies – one Danish and the other, a German hospital – the paper assesses the future potential of different private sector participation strategies in health care.

The assessment is that low-level private sector participation approaches such as outsourcing and concession models remain limited and specialised financing instruments for health care in Denmark and Germany due to legal restrictions and lesser importance being placed on operational financial savings and improved management than on achieving strategic goals. Furthermore, existing approaches do not necessarily prepare the ground for public-private partnerships.

To date, longitudinal studies of private sector participation in health care are almost non-existent for continental Europe, yet critical for the assessment of the outcomes of long-term projects of ten to 40 years' duration. In addition, there is still a need for more international comparisons, especially for studies comparing more than two countries.

Case studies about private sector participation in health care with transnational European or international comparisons are very scarce. The paper, which compares two cases of a Danish and a German hospital, is therefore a contribution to reducing a relevant research gap. To date, private sector participation in the German health system, in particular, has rarely been discussed in international journal publications.

This article looks at the alignment of performance management system with the strategy, structure, and organizational outcome in Canadian health care organizations. In this study, balanced scorecard is the framework adopted for assessing the health care organization's performance management system (PMS) and outcome. CEO and clinical unit managers were surveyed for their perceptions on their organization's strategy, autonomy structure, PMS, and organizational performance. Path analysis was the methodology used in examining the relationship about the above organizational variables. The results indicate that patient satisfaction is the primary and most significant perspective of the depicted balanced scorecard in organizational performance. Patient satisfaction and research criteria, on the other hand, are the significant perspectives of a balanced scorecard in an organization's PMS, which are linked to strategy, autonomy structure, and organizational performance. Moreover, the results show that the strategy/structure links operated as suggested. Surprisingly, strategy on service innovation has a negative impact on the organizational outcome of patient satisfaction. Uncertainty from continuous development and organizational change in pursuing service innovation and cost-cutting measures in response to fiscal constraints are plausible explanations of the adverse impact reported.

Tourism industry is a profitable resource for countries and considered one of the main sources of income and job creation for economic development. Among the various types of tourism, medical tourism and its subsets are of great significance owing to their capabilities and competitive advantages. In this regard, the purpose of this research is to provide a framework to categorize customers based on the Zeithaml pyramid and then identify and provide strategies to create loyalty and attract customers of this industry.

This study proposed a framework for medical tourists' satisfaction and loyalty. First, by studying the literature and data gathering from Yazd (one of the cities of Iran), the effective factors on the loyalty and attraction of medical tourists were identified. These factors have been prioritized for the medical tourists who are in the platinum category by the Pareto technique and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) method. Next, the strategies provided by experts for loyalty and attraction of medical tourists were examined. Finally, the house of quality (HOQ) as the first matrix in quality functional deployment (QFD) was used to provide operational strategies for medical tourism satisfaction. The statistical population of this research consists of medical tourists, academic experts and active physicians of medical tourism in Yazd, one of the cities of Iran.

The study results indicate the importance of “hospital reputation” in medical tourists' satisfaction. Also, “achieving international standards”, “periodic customer satisfaction assessment” and “paying attention to social responsibilities” are recognized as the most important strategies to achieve the loyalty of the most profitable group of customers, namely platinum.

This study covers both theoretical and practical aspects. Theoretically, this study developed a new framework for medical tourists' satisfaction by the Zeithaml matrix, TOPSIS, Pareto technique and QFD method. Furthermore, practically this study helps practitioners of medical tourism in medical tourists' satisfaction and loyalty.

In this study, in addition to identifying the effective factors on the loyalty and attracting medical tourists, a new framework was developed for medical tourists' satisfaction by segmentation the tourism by the Zeithaml matrix and providing operational strategies by the QFD technique.

This paper is specifically developed on the basis of a pragmatic model for the Muslim-friendly medical tourism supply chain industry. The purpose of this study is to investigate the effectiveness and viability of the Muslim-friendly medical tourism supply chain practices in Malaysia.

A framework for the service supply chain management of the Muslim-friendly medical tourism with the effective outcomes was theoretically developed and explored in this study, using a structural equation modelling with the partial least squares technique. A structured questionnaire was developed, distributed and collected from 38 Islamic-friendly hospitals, 9 Muslim-friendly medical agencies and 44 Muslim-friendly hotels that will form the potential relevant associations of the medical tourism supply chain practices in Malaysia.

The findings provide reliable evidence that the effectiveness of the Muslim-friendly medical tourism supply-chain practice has a positive impact on the Muslim-friendly medical tourism supply chain. In addition, the Muslim-friendly medical tourism supply chain practice has also a significant and positive impact on the organizational performance as a whole. The result also demonstrates that collaboration is dependent on the demand management, whilst the productivity is not associated with it.

Practicing and implementing a Muslim-friendly medical tourism service supply chain is important, in the sense that the Muslim patients’ demand on the choice of halal practice of medical treatment and halal food consumption criteria. This investigation is the first to embark on the research on the Muslim medical tourism supply chain production network in Malaysia. This study provides practitioners with the important related data to improve their policies and their performances in the organization. The statistical results provide indispensable valuable information in comprehending the critical medical tourism supply chain practices and most specially to assist the Muslim-friendly medical tourism sector to offer quality medical tourism service that suits and attracts the Muslim medical tourists’ broad needs regionally and abroad.