Characteristics of pediatric e-referrals through SMARC system: a two-year national analysis

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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: = 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%). Conclusion: 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.

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