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Updated: Mar 29, 2026

A Precision Medicine Tool for Measurement and Monitoring of Hemoglobin S in Sickle Cell Disease Patients Receiving Transfusion Therapy
Factors Associated with Healthcare Utilization in Children with Sickle Cell Disease in Saudi Arabia
Daniya Sabrah1, Seyed M Karimi1, Bert Little1
1Department of Health Management and Systems Sciences, School of Public Health, University of Louisville, Louisville, KY 40202, USA.
Insights
Sickle cell disease (SCD) in Saudi children shows higher healthcare use in eastern, western, and southern regions. Clinical factors like complications and crises significantly impact inpatient, outpatient, and emergency visits.
Area of Science:
- Pediatric Hematology
- Public Health
- Healthcare Management
Background:
- Sickle cell disease (SCD) presents a significant pediatric health challenge in Saudi Arabia.
- Despite a publicly funded healthcare system, understanding healthcare utilization patterns is crucial.
Purpose of the Study:
- To identify factors influencing inpatient (IP), outpatient (OP), and emergency department (ED) visits for children with SCD in Saudi Arabia.
Main Methods:
- Retrospective observational study using KAIMRC registry data (2015-2023).
- Analyzed 450 children under 12 with SCD using negative binomial regression.
- Considered clinical, demographic, and regional healthcare variables.
Main Results:
- Inpatient visits linked to complications, crisis episodes, and specific regions (eastern, western, southern).
- Emergency visits associated with complications, crises, and hydroxyurea; inversely related to bone marrow transplant.
- Outpatient visits increased with comorbidity index, age, and bone marrow transplant; lower in the eastern region.
Conclusions:
- Clinical factors and geographic region significantly influence healthcare utilization for pediatric SCD.
- These factors are important even within Saudi Arabia's equitable, high-resource healthcare system.
Abstract:
(1) Background: In Saudi Arabia, a high-income country with a publicly funded healthcare system, sickle cell disease (SCD) remains a major pediatric health challenge. This study aimed to identify factors associated with healthcare utilization, specifically inpatient (IP), outpatient (OP), and emergency department (ED) visits, among children with SCD in Saudi Arabia. (2) Methods: A retrospective observational study was conducted using data from the KAIMRC registry (2015-2023), including 450 children under 12 years old diagnosed with SCD. Negative binomial regression models were employed to analyze the annual average visits, accounting for clinical, demographic, and regional healthcare resource variables. (3) Results: Key predictors of IP visits included complication count, crisis episodes, and region (eastern, western, and southern regions had higher utilization than central). ED visits were positively associated with complications, crisis episodes, and hydroxyurea use, but negatively associated with bone marrow transplant receipt. OP visits increased with higher Charlson Comorbidity Index scores, age, and bone marrow transplant, but were lower in the eastern region. (4) Conclusions: These findings highlight the influence of clinical and regional factors even within an equitable, high-resource healthcare system.
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