Influence of Ramadan on demand analysis of trauma related surgical activities and hospital resource services: An institution experience in the Middle East.

Abstract

Background and Objectives: To examine the utilization of critical hospital resources: bed utilization, operating room activities, median length of stay (LOS) during the month of Ramadan at a major tertiary trauma center in the Middle East. Methods: Consecutive trauma admissions requiring major surgical operative interventions at the Rashid Hospital Trauma Center (RHTC) in Dubai, United Arab Emirates during the month of June in 2008 and September (Ramadan) in 2008 were reviewed. Data extracted from the hospital's theatre registry and medical records were analyzed. Resources utilization of all operative trauma cases admitted to the hospital were correlated with the overall injury status of the patients based on the Injury Severity Score (ISS) and the Revised Trauma Score (RTS). Results: There were 1647 surgical procedures performed in 939 trauma patients who underwent surgical interventions during the study period, showing no significant change in Operating Room volume activities. The data indicates an increase in length of stay per ISS in the month of Ramadan. Of more significance, the data demonstrates a 68 % increase in occupied beds days despite no significant increase in patient volume during the month of Ramadan in comparison with the month of June. Conclusions: During the month of Ramadan, there has been an increase in consumption of hospital resources in terms of bed stays in particular with minor and moderate injuries ISS 1-8, and 9-15. Trauma related surgical procedures were not statistically increased during the month of Ramadan. The RHTC median LOS by ISS is more than doubled than the National Trauma Data Bank (NTDB) during Ramadan, resulting in unnecessary consumption of valuable resources. Unnecessary hospital stay increases risk of further complications to patients, resulting in further delays in discharge.