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ORIGINAL RESEARCH article

Front. Med.

Sec. Family Medicine and Primary Care

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1665256

This article is part of the Research Topic25 Years of 21st Century MedicineView all 20 articles

Characteristics of Pediatric E-referrals Through SMARC System: A Two-year National Analysis

Provisionally accepted
Abdullah A. AlharbiAbdullah A. Alharbi1Mohammed A. MuaddiMohammed A. Muaddi1*Meshary S. BinhotanMeshary S. Binhotan2,3Ahmad Y. AlqassimAhmad Y. Alqassim1*Ali K. AlsultanAli K. Alsultan4Mohammed S. ArafatMohammed S. Arafat4Abdulrahman AldhabibAbdulrahman Aldhabib4Yasser A. AlaskaYasser A. Alaska5Eid B. AlwahbiEid B. Alwahbi4Hussain A. MoafaHussain A. Moafa6Gassem GohalGassem Gohal6Mohammed K. AlabdulaaliMohammed K. Alabdulaali7Nawfal A. AljerianNawfal A. Aljerian3,4,8
  • 1Family and Community Medicine Department, Faculty of Medicine, Jazan University, 45142, Jazan, Saudi Arabia
  • 2Emergency Medicine Department, King Saud bin Abdulaziz University for Health Sciences, 11481, Royadh, Saudi Arabia
  • 3King Abdullah International Medical Research Centre, 11481, Riyadh, Saudi Arabia
  • 4Medical Referrals Centre, Ministry of Health, 12382, Riyadh, Saudi Arabia
  • 5Department of Emergency Medicine, King Saud University, 11461, Riyadh, Saudi Arabia
  • 6Pediatric Department, Faculty of Medicine, Jazan University, 45142, Jazan, Saudi Arabia
  • 7Ministry of Health, 12382, Riyadh, Saudi Arabia
  • 8Emergency Medicine Department, King Saud bin Abdulaziz University for Health Sciences, 11481, Riyadh, Saudi Arabia

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Background: Electronic referral (e-referral) systems are increasingly vital for coordinating pediatric healthcare services, yet comprehensive analyses of nationwide implementation remain limited. This study examines patterns, outcomes, and system performance of pediatric e-referrals across Saudi Arabia's healthcare network. Methods: We conducted a retrospective analysis of all pediatric e-referrals (n=62,206) processed through the Saudi Medical Appointment and Referral Center between January 2023 and December 2024. Data analysis included referral types, subspecialty distribution, regional patterns, acceptance rates, and temporal trends. Results: Male patients represented 54.19% of e-referrals. We found a predominance of routine outpatient referrals (56.98%), with urgent and lifesaving cases comprising 32.41%. The overall acceptance rate was 91.52%, with 100% acceptance for lifesaving cases. Internal referrals constituted 82.85% of cases. General Pediatric Care (31.61%) accounted for most e-referral followed by Pediatric Cardiology (12.12%), Neurological Diseases (11.79%) and Neonatal Care (11.21%). Temporal analysis revealed an increase in overall referrals from 2023 (48.74%) to 2024 (51.26%). Conclusions: This first comprehensive analysis of Saudi Arabia's pediatric e-referral system demonstrates successful implementation of a coordinated care network with high acceptance rates and effective regional self-sufficiency. The findings provide valuable insights into healthcare planning and resource allocation. These findings offer transferable insights for international healthcare systems implementing pediatric e-referral platforms and digital health initiatives.

Keywords: Electronic referral, Pediatric healthcare, Healthcare Coordination, Saudi Arabia, healthcare systems, Digital Health

Received: 12 Aug 2025; Accepted: 21 Oct 2025.

Copyright: © 2025 Alharbi, Muaddi, Binhotan, Alqassim, Alsultan, Arafat, Aldhabib, Alaska, Alwahbi, Moafa, Gohal, Alabdulaali and Aljerian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mohammed A. Muaddi, mothman@jazanu.edu.sa
Ahmad Y. Alqassim, aalqassim@jazanu.edu.sa

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material