Pediatric emergency department utilisation during Ramadan: a retrospective cross-sectional study

Abstract

ObjectiveTo investigate the impact of Ramadan on patient characteristics, diagnoses and metrics in the paediatric emergency department (PED).DesignRetrospective cross-sectional study.SettingPED of a tertiary care centre in Lebanon.PatientsAll paediatric patients.ExposureRamadan (June 2016 and 2017) versus the months before and after Ramadan (non-Ramadan).Main outcome measuresPatient and illness characteristics and PED metrics including peak patient load; presentation timings; length of stay; and times to order tests, receive samples and report results.ResultsWe included 5711 patients with mean age of 6.1±5.3 years and 55.4% males. The number of daily visits was 28.3±6.5 during Ramadan versus 31.5±7.3 during non-Ramadan (p=0.004). The peak time of visits ranged from 18:00 to 22:00 during non-Ramadan versus from 22:00 to 02:00 during Ramadan. During Ramadan, there were significantly more gastrointestinal (GI) and trauma-related complaints (39.0% vs 35.4%, p=0.01 and 2.9% vs 1.8%, p=0.005). The Ramadan group had faster work efficiency measures such as times to order tests (21.1±21.3 vs 24.3±28.1 min, p<0.0001) and to collect samples (50.7±44.5 vs 54.8±42.6 min, p=0.03).ConclusionsRamadan changes presentation patterns, with fewer daily visits and a later peak time of visits. Ramadan also affects illness presentation patterns with more GI and trauma cases. Fasting times during Ramadan did not affect staff work efficiency. These findings could help EDs structure their staffing to optimise resource allocation during Ramadan.

Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review

“…7 8 9 10 11 12 13 The salient findings of these and other studies are discussed below. 7 8 9 10 11 12 13 14 15 16 17 18 19 20…”

“…Also, Halasa found more patients presenting during the night hours than during daytime hours, echoing previous results; however, he found a larger proportion of younger patients presented with respiratory tract infections during Ramadan. 11 Finally, Balhara et al 13 examined patients in the United Arab Emirates (UAE) and Sawaya et al 20 examined patients in Lebanon, they both observed a reduction in pediatric patient group attendance, with Balhara et al noting a decrease in the length of stay in this group of patients.…”

“…[7][8][9][10][11][12][13] The salient findings of these and other studies are discussed below. [7][8][9][10][11][12][13][14][15][16][17][18][19][20] One study from Qatar found that Ramadan was not associated with the change in patient age or the proportion of high-acuity cases. However, it was associated with an increase in the proportion of male, pediatric, and Qatari national patient visits.…”

Ramadan fasting in health and disease (2020): A narrative review

“…The impact of Ramadan on emergency services was reported from two studies. [65][66][67] Faruqi et al [65] analyzed the emergency department (ED) patients' flow during Ramadan and compared it to NR days in a retrospective study from Abu Dhabi, UAE. It was conducted at a tertiary hospital (2014)(2015)(2016).…”

“…Moreover, the authors observed a difference in the patient arrival pattern between the Ramadan and NR days and the predominant categorization of chief patient complaints. Sawaya et al [66] investigated the impact of Ramadan on patient characteristics, diagnoses, and metrics in the pediatric ED (PED). In a retrospective cross-sectional study, all pediatric patients attending the PED of a tertiary care center in Lebanon were included during Ramadan (June 2016 and 2017) versus the months before and after Ramadan (NR).…”