Aims: To determine the decision time (DT) in the Emergency Department (ED) to establish the factors that prolong DT. Methods: This was a prospective study performed between November 17 and December 18, 2005, involving patients who had been admitted to the ED and whose transfer to other hospitals was decided. We used "The Patient Transfer Questionnaire", which included the date of transfer, demographics of the patient, and the physician's decision of the time of transfer. The statistical variables were assessed using SPSS. Results: A total of 507 patients were included, of whom 53.4% were male. The most frequent diagnoses in transferred infants, children, adolescents, and adults were infection, convulsion or epilepsy, acute abdomen, and coronary syndrome, respectively. There was a significant correlation between age groups and the main diagnosis (trauma vs. no trauma). The mean DT was 37.7 ± 1.6 min. The longest DT was due to a lack of critical care beds; the shortest DT was determined for infants. The differences in DT between age groups, reasons for transport, and the patients' in-hospital consultation before the decision to transport were statistically significant. Age groups were found to be the most significant indicators in the DT. Conclusion: The organization of the services in the hospital directly affects the secondary DT. © TÜBİTAK.