Epidemiology and Patterns of Pediatric Visits and Referrals in a Model Primary Health Care Centre in Saudi Arabia: A Retrospective Chart Review Study

Background: Primary healthcare plays a vital role in delivering pediatric services. This study aimed to examine the epidemiology of pediatric visits to a model primary healthcare (PHC) center and identify factors associated with referrals to specialized care. Methods: A retrospective chart review was conducted for all pediatric visits between January and December 2024 at a model PHC center affiliated with an academic medical city in the Kingdom of Saudi Arabia (KSA). Descriptive statistics, chi-squared tests, and multivariable logistic regression were used to assess predictors of referral. Diagnoses were categorized, and clinic types stratified to explore seasonal and diagnostic trends. Ethical approval was obtained prior to data access. Results: A total of 4520 pediatric visits were analyzed. Just over half of the patients were female, and the largest age group was school-aged children (38.1%). Visit frequency peaked in winter and spring. Most visits (78.4%) were first-time consultations, and the majority occurred in general family medicine clinics. Overall, 10.95% of visits resulted in referrals. Referrals were more common during outpatient consultations than urgent care visits and were strongly associated with specific diagnoses, particularly neurological (aOR = 11.73), eye (aOR = 8.77), ENT-related conditions (aOR = 7.73), and genitourinary or pubertal conditions (aOR = 6.60). Demographic variables such as sex and nationality were not significant predictors. Conclusions: The observed referral rate may indicate effective gatekeeping within Saudi primary care, though referral frequency alone cannot determine appropriateness. Enhancing diagnostic support and behavioral health integration could further optimize referral practices and support Vision 2030 goals for strengthened child health services.