الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Diabetes mellitus is one of the most challenging health problems in the 21 sr century.
It is the fourth or fifth leading cause of death in most high-income countries and there is
substantial evidence that it is epidemic in many low-middle-income countries (173)
Complications from diabetes, such as coronary artery and peripheral vascular disease,
stroke, diabetic neuropathy, amputations, renal failure and blindness are resulting in
increasing disability, reduced life expectancy and enormous health costs for virtually every
. (174)
society .
In adults, DM is now recognized as a particular threat to the public health of the third
world communities, particularly those living in rapidly developing countries. Moreover,
DM is considered as a global epidemic with devastating human, social and economic
consequences (28).
The Middle East Region has not been spared from this scourge and currently is
among those worst hit. Prevalence of DM is highly variable among different population.
Reported prevalence data from International Diabetic Federation (IDF) revealed that high
rates at diabetes were observed in Saudi Arabia (24%), Kuwait (23.1 %), and Qatar (22.9%)
in the year 2013(24,25,28).
Egypt is one of the biggest developing countries that witnessed major life style
changes and a rapid epidemiologic transition in the past decades, which were reflected in a
significant rise in DM prevalence rate. According to the International Diabetic Federation
(IDF), the prevalence rate was 7.5% in the year 2013 with expected prevalence l3.1% in
the year 2035. Also, DM is the eleventh most important cause of premature mortality and
is considered as the six most important cause of disability burden in Egypt.
Patients and staff satisfaction is an important component of the health care industry
in this competitive modern area. Patients’ satisfaction leads to drift in both new and old
patients, which hinders the sustainability of any hospital in long run.
The ultimate purpose of quality assessment in health care is to improve the
effectiveness of health service programs. Quality assessment not only shows the outcome
or accomplishment of services and programs in relation to the standard but it may also
suggest points of difficulty and efforts that can be focused on to identify the links in the
chain. The quality assessment of health care considers the three- parts approach (i) the
structure: which includes the attributes of the material resources, human resources and
organizational structures, (ii) the process which denotes what is actually done in providing
and receiving care e.g. making a diagnosis and implementing treatments and (iii) the
outcome which denotes the effect of care on the health status of the patient and the general
population.