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Healthcare Utilization and Economic Burden of Pediatric Lower Respiratory Tract Infections Across Five Tertiary
Nawaf M Almuqati1, Mohammed Y Al-Hindi1,2,3, Hibah A Moussa4
1College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 9515, Saudi Arabia.
Insights
Lower respiratory tract infections (LRTIs) in young children significantly burden healthcare systems in Saudi Arabia, with intensive care unit (ICU) admissions driving most costs. Bronchiolitis and pneumonia are common, with higher ICU risk for pneumonia.
Area of Science:
- Pediatric infectious diseases
- Health economics
- Epidemiology
Background:
- Lower respiratory tract infections (LRTIs) are a major cause of childhood morbidity and mortality globally.
- Understanding the healthcare utilization and economic impact of LRTIs in specific populations is crucial for resource allocation and public health planning.
Purpose of the Study:
- To describe the healthcare utilization and economic burden of LRTIs in children aged 1-24 months.
- To identify factors associated with severe outcomes like hospitalization and ICU admission.
- To analyze the cost implications of LRTIs in a Saudi Arabian tertiary care setting.
Main Methods:
- A multicenter retrospective cohort study involving 14,320 children diagnosed with LRTIs between August 2021 and July 2025.
- Data extracted from electronic medical records, including demographics, diagnoses, healthcare resource use, and costs.
- Descriptive statistics, inferential statistics, and multivariable logistic regression were used for analysis.
Main Results:
- Over 22,000 LRTI episodes were analyzed, with bronchiolitis (84.6%) and pneumonia (15.1%) being predominant diagnoses.
- 34.4% of patients required hospitalization, and 7.1% needed ICU admission, with LRTIs constituting 21.0% of pediatric ward admissions.
- Total direct healthcare costs amounted to USD 23.0 million, with ICU admissions accounting for 45.1% of expenditures despite representing only 7.1% of episodes.
- Pneumonia diagnosis was independently associated with higher odds of ICU admission (aOR 2.91).
- LRTI episodes showed significant seasonal variation, peaking in winter months.
Conclusions:
- Pediatric LRTIs represent a substantial clinical and financial burden in Saudi Arabia.
- Younger infants and those with pneumonia face a higher risk of severe outcomes and increased healthcare costs.
- Targeted interventions and resource management are needed to mitigate the economic and clinical impact of LRTIs, particularly focusing on high-cost ICU care.
Objectives:
We aimed to describe the healthcare utilization and economic burden of lower respiratory tract infections (LRTIs) among children aged 1-24 months across five tertiary hospitals in Saudi Arabia.
Methods:
This multicenter retrospective cohort study included 14,320 children diagnosed with LRTIs between August 2021 and July 2025. Data were extracted from the electronic medical records of the Ministry of National Guard Health Affairs. Demographics were analyzed using a patient-level dataset, whereas healthcare utilization and costs were evaluated at the episode level. Data were analyzed using descriptive and inferential statistics and multivariable logistic regression.
Results:
A total of 14,320 children contributed 22,895 LRTI-related episodes during the study period. Nearly half of the cohort (49.4%) were aged 1-6 months, and bronchiolitis was the predominant diagnosis (84.6%), followed by pneumonia (15.1%). Overall, 34.4% of patients required hospitalization, while 7.1% required ICU admission. LRTIs accounted for 21.0% of all pediatric ward admissions across participating hospitals. Total direct healthcare costs reached USD 23.0 million. Although ICU admissions represented only 7.1% of episodes, they accounted for 45.1% of total healthcare expenditures. In multivariable analysis, pneumonia was independently associated with higher odds of ICU admission compared with bronchiolitis (aOR 2.91, 95% CI 2.43-3.48; p < 0.001). Significant seasonal variation in LRTI episodes was observed, with higher episode volumes during winter months (p = 0.004).
Conclusions:
Pediatric LRTIs impose substantial clinical and financial burdens, particularly among younger infants, marked by disproportionate ICU-related costs.
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