OBJECTIVES: Dialysis patients have a chronic renal insufficiency. For these patients process characteristics of their treatment are important. Therefore this study aimed at the development and testing of a questionnaire to assess the quality of care in Dutch dialysis centers from the patients perspective: the Quality of Care in Dialysis centers (QCD) questionnaire. METHODS: In a literature study possible sets of dimensions were identified. Four focus group sessions were organized, with 27 patients in total. The results from the focus groups were transformed into a 68-item test version of the QCD. This version was discussed with four nephrologists and seven patients. A 'visual analogue scale' (VAS) was added to determine overall satisfaction. The final test version was sent to 300 patients in a postal setting. Factor analysis was applied and item reductions were conducted. RESULTS: Statistical analyses was based on 140 out of the 162 returned questionnaires. The results from the factor analysis confirmed the use of the set of dimensions with the dimensions: doctors, nurses, other staff members, and facilities. The test version of the QCD instrument, was found to be both construct valid and content valid. The instrument is reliable, with Cronbach's alpha of a=0.91, a=0.86, a=0.85 and a=0.83 for four factors. After item reduction 36 items and the VAS remained. Each dimension consists of 8 specific items and one item about the overall satisfaction with that dimension. The 36-item QCD is also content valid, construct valid and reliable (a=0.83 and a=0.84 for two factors). CONCLUSIONS: The QCD can be used in Dutch dialysis centers. Further research will be conducted to establish preference weights per dimension on the basis of the VAS scores. These preference weights can be applied in benchmark procedures to assess the quality of care in a dialysis center.