Background: The Emergency Room (ER) is one of the most used areas in healthcare institutions. Problems with over utilisation and overcrowding have been reported worldwide. This study aims at examining the characteristics of paediatric ER visits, the rate of hospital admissions and its associated predictors at King Fahd Hospital of the University in the Eastern Province of Saudi Arabia. Methods: This is a retrospective, medical record-based study. Variables included gender, age group, nationality, complaints, Triage level, shifts and seasons. Descriptive statistics were reported as frequencies/percentages. P-values were obtained through a Chi-Squared test while unadjusted and adjusted odds ratios were estimated by binary logistic regression, where admission was considered as the outcome. Results: The total number of paediatric patients included was 46,374, and only 2.5% were admitted. Males comprised 55.4% while females comprised 44.6%. The most common age group were toddlers, and 92.4% of the total sample were Saudis. The most common complaint was fever (26.9%) followed by respiratory symptoms (24.9%). Only 7 patients (0.02%) were classified as triage I (Resuscitation), and most were triage IV (Less urgent) (71.0%). Most visits occurred during the winter months. Adjusted ORs showed that neonates had higher odds of admission (OR = 3.85, 95%CI = 2.57–5.76). Moreover, those presenting with haematological conditions showed an OR of 65.49 (95%CI = 47.85–89.64), followed by endocrine conditions showing an OR of 34.89 (95%CI = 23.65–51.47). Triage I had a very high odds of admission (OR = 19.02, 95%CI = 2.70–133.76), whereas triage V was associated with a very low odds of admission (OR = 0.30, 95%CI = 0.23–0.38). Conclusions: A low rate of hospital admission was found in comparison with other rates worldwide. This was mostly attributed to an alarmingly high number of non-urgent ER visits. This further emphasises the problem with improper use of ER services, as these cases should be more appropriately directed towards primary healthcare centres. Further studies to examine the impact of prioritising patients in the ER based on the identified predictors of hospital admission, in addition to the standard triage system, are suggested.

This study aimed to identify the characteristics of pediatric primary health care (PHC) visits and evaluate the outcomes of patients presenting with complaints along with their referral and consultation capabilities. This was a retrospective medical record-based study. The study population included any pediatric patient (≤14 years old), including females and males, Saudis, and non-Saudis. Research data were gathered for visits from 2016–2021. Sampling was performed using a stratified random sample based on age groups, followed by simple random sampling with proportional allocation to different age groups. The number of pediatric visits included was 1439 (males, 52.2%). The most common age group was toddlers, and 60% of the total sample was from Saudi Arabia. The most common cause of visits was vaccination (32%), followed by general checkups and/or a well-baby visit (25.4%), and fever (11.2%). Approximately 10% of visits needed referral to other subspecialties. Approximately 50% of visits with complaints concerning ophthalmology, cardiology, and surgical intervention were referred to a specialized department. More awareness needs to be raised about the important role of PHC services in the pediatric age group, as it was capable of handling approximately 90% of their cases.

Background: The COVID-19 pandemic has significantly impacted many aspects of healthcare, particularly pediatric visits to primary healthcare (PHC). Difficulties associated with PHC in this delicate age group can result in substantial complications. Objective: This study aims to determine the impact of the COVID-19 pandemic on pediatric primary care delivery by examining patient characteristics, the number and types of visits, and their relationships both before and after the pandemic. Methods: This comparative cross-sectional study (pre-COVID-19 and COVID-19) utilized register-based data of children aged ≤14 years old, including both Saudi and non-Saudi females and males. Data collection spanned from 2016 to 2021. Sampling was conducted using a stratified random sampling method based on age groups, followed by a simple random sampling technique with proportional allocation to each age group. Results: A total of 1,439 pediatric visits were included in this study, with males accounting for 52.2% of the sample. The most highly represented age group was toddlers, and 60% of the sample were Saudis. Vaccination was the most common reason for visits, accounting for 32% of the cases, followed by general and well-baby checkups, constituting 25.4%. During the COVID-19 pandemic, there was an increase in visits related to general and well-baby checkups, vaccinations, and psychiatry compared to the pre-COVID-19 period. Conversely, visits for fever, dermatology, ENT (ear, nose, and throat), gastrointestinal (GI), and respiratory conditions decreased during the COVID-19 pandemic compared to the pre-COVID-19 period. Moreover, there was a statistically significant increase in referrals to the ophthalmology department in contrast to a decrease in referrals to the emergency department (ED) compared to the pre-COVID-19 period. Conclusion: The COVID-19 pandemic resulted in a significant impact on pediatric visits to PHC. Awareness of families regarding the well-baby clinic and vaccination visits reflects a positive attitude, emphasizing the importance of this during and after the pandemic will contribute to the overall wellbeing of the pediatric population. In addition, greater effort should be made to provide mental health PHC visits to protect and support this age group in future pandemics.