الفهرس 
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Abstract
Pediatric emergency services are considered as one of the most important branches of the health care system, because it deals with a delicate and sensitive group of the population. The difference between life and death, between health and diseased state in pediatrics are measured by the fraction of a second, so there must be rapid comprehensive EMS-C which provide all types of services for stabilization of patients. Some studies based on assessment of quality of care were done utilizing the parameters of structure and /or process and/or outcome measures.These studies revealed that there is a shortage and low level of EMS-C quality in different areas of service delivery and absence of standard methods in management of cases from one unit or hospital to the other. Studies also revealed absence of systematic training programs for health services providers. Consequently, the importance of the present study becomes clear and prominent which is to explore the aspects or areas of weakness in relation to the structure of the EMS-C as well as the abilities of the providers in dealing with the emergency cases and the process of care of these emergency cases, and as a result the outcome of care measured by patients` relatives satisfaction with the services provided. The aim of the study is assessment of the quality of pediatric emergency services provided to children under 5 years old by health units and hospitals in Beheira governorate. This would be achieved through two main sub objectives: The first one is to reveal the types and frequency of emergency cases among children under 5 years.The second is to assess the quality of these services through 3 approaches: structure, process and outcome of care through patients relatives’ satisfaction with the services provided. This study was carried out as a cross sectional study in the emergency rooms and departments of 15 health units, 2 rural hospitals, 3 district hospitals in addition to Damanhour Teaching hospital. All cases less than 5 years old attending these units and hospitals for emergency services were included. Total number of pediatric cases included in this study amounted to 502. Data were collected through different types of prepared observational checklists and questionnaire forms prepared by the researcher under supervision of the research supervisors The structure and process criteria used in these forms were selected from literature review as well as from forms used in previous researches: These forms were then reviewed by a special panel of experts to determine the appropriateness of application of these items in Egyptian health organizations. The process of care was measured through assessment of the quality of care presented to cases of acute respiratory conditions, which represented the highest percent of acute cases seen in the emergency rooms and departments. Patients` relatives satisfaction with the services provided, was the parameter of assessment of outcome of care and was assessed by a questionnaire form which included items of satisfaction as accessibility, receptionist waiting time and waiting room….etc. Patients` relatives also were asked about their recommendations for improvement of services. Physicians` personal data and opinion about service improvement were also covered. Results of the study revealed the following: - DTH and more than 30