The patient population presenting to this hospital is predominantly Muslim. This retrospective study is an attempt to find out whether these social, cultural and religious factors during the month of Ramadan impact ED volume, triage acuity, admission rate and patient demographics in a tertiary care hospital in Riyadh, Saudi Arabia. 11 During Ramadan, social activities like shopping and family recreational activities are more frequent after people have broken their fast and during the night time. 9, 10 It is quite conceivable that some of these patients may present to an ED with sickness or injury. 8 One epidemiologic study indicated that a majority (79%) of patients with type 2 diabetes fasted for at least 15 days during Ramadan and in another study over half (58%) of peritoneal dialysis patients elected to fast. 6, 7 However, many of these individuals attempt fasting to fulfill their religious obligations.
5 Islam does not mandate fasting for sick persons, children, elderly, travelers, insane, pregnant or lactating and menstruating women. During Ramadan the change in the sleep-wake cycle is associated with changes in meal schedules, increased food consumption during the night, a decrease in daytime alertness and psychomotor performance and an increase in the intensity of certain diseases. During summer months the fasting period may be 18 hours long in the region. As a lunar calendar is shorter than the Gregorian calendar by 11 days, Ramadan may fall any time of the year. Depending on the sighting of the moon, this may be 29 or 30 days. 4 Muslims follow a lunar calendar and Ramadan is the 9th month. 3ĭuring Ramadan, healthy Muslims do not eat, drink, smoke or have sexual intercourse from dawn to sunset. 2 Also, due to a worldwide shortage of trained and qualified emergency staff, physicians, mid-level providers and nurses, appropriate staffing schedules are required for optimal patient outcomes.
Cost-effective ED staffing plans account for historic patient volumes during peak and trough hours. To optimize the quality of patient care, efficient patient flow, shorten waiting times and length of stay, a balance between the supply of emergency resources and demand for services must be maintained. 1 ED patient attendance patterns may change during local community events, school holidays, sudden influxes of visitors in town or a festivity such as Ramadan (Muslim month of fasting). The demand for services changes due to seasonal and weekly patterns. Emergency Department (ED ) patient visits have an inherent natural variability through the day and month to month.
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