• Rana Saleh, Maha Makki, Hani Tamim, and Eveline Hitti.
• Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
• J Emerg Med. 2020 Nov 1; 59 (5): 720-725.

BackgroundEmergency departments (EDs) worldwide experience substantial variability in hourly patient arrivals. The month of Ramadan represents a repetitive annual occurrence, which could be associated with distinct patient arrival patterns compared with other months of the year.ObjectiveThis study examined hourly patient arrival patterns and patient characteristics in an ED in a tertiary care center in Beirut, Lebanon to determine whether there are significant changes in patient attendance patterns during the month of Ramadan.MethodsData on patients presenting to the ED during the month of Ramadan with those presenting 1 month prior to and 1 month after, between 2012 and 2018, were accounted for in the study. Pearson chi-squared test was used in the bivariate analysis, whereas Student's t-test was used to compare continuous variables.ResultsPatient attendance patterns significantly varied between Ramadan and non-Ramadan periods (p < 0.0001). Patient flow dropped starting at 8:00 am, with the greatest drop between 6:00 pm and 9:00 pm, and increased in the early morning hours between 2:00 am and 4:00 am (p < 0.0001). The total number of visits per day significantly decreased in Ramadan compared with non-Ramadan periods (135.6 ± 14.74 vs. 145.5 ± 18.90, p-value < 0.0001), whereas length of stay decreased slightly.ConclusionWe found a drop in daily ED visits during Ramadan, in addition to a distinct pattern of patient arrivals. ED administrators should consider different scheduling arrangements for nurses and physicians during this period in EDs that serve communities where Ramadan is commonly observed.Copyright © 2020 Elsevier Inc. All rights reserved.

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