Healthcare Utilization and Economic Burden of Pediatric Lower Respiratory Tract Infections Across Five Tertiary Hospitals in Saudi Arabia

Nawaf M. Almuqati ¹, Mohammed Y. Al-Hindi ^1,2,3,*, Hibah A. Moussa ⁴, Sama H. Alzahrani ⁴, Manar A. Almuntashri ¹, Mansour A. Al-Qurashi ^1,2,3, Mawyah O. Barayyan ⁵ and Shaykhah M. Bin-Sifran ⁶

Healthcare Utilization and Economic Burden of Pediatric Lower Respiratory Tract Infections Across Five Tertiary Hospitals in Saudi Arabia

Study Design & Setting:

• Multicenter retrospective cohort study
• Five tertiary hospitals across Saudi Arabia
• Children aged 1–24 months
• Real-world healthcare utilization and economic burden analysis

Study Objectives:

• Assess healthcare utilization patterns in pediatric LRTIs
• Evaluate direct economic burden
• Characterize hospitalization and ICU resource utilization

Study Population:

• 22,895 LRTI episodes analyzed
• Mean age: 8.2 months
• Bronchiolitis was the predominant diagnosis (84.6%)

Diagnosis Distribution Among Pediatric LRTI Episodes

Bronchiolitis represented the predominant diagnosis among pediatric LRTI episodes across Saudi tertiary hospitals.

Substantial Hospitalization and ICU Burden Observed in Pediatric LRTIs

Healthcare Utilization Overview:

• LRTIs accounted for 21% of pediatric ward admissions
• 34.4% of episodes required hospitalization
• 7.1% of episodes required ICU admission

Seasonality:

• Higher case volumes were observed during winter months
• Consistent with seasonal circulation of respiratory viruses, particularly RSV

Key Takeaway:

• Although ICU admissions were less frequent, they represent a substantial driver of healthcare burden.

Patient Flow and Resource Utilization

Despite representing only 7.1% of episodes, ICU admissions contribute disproportionately to the overall healthcare burden.

Higher case volumes were observed during winter months, consistent with seasonal circulation of respiratory viruses, particularly RSV

ICU Admissions Drove a Disproportionate Share of Direct Healthcare Costs

Total Direct Cost

Approximately

USD 23.0 million

across 22,895 episodes

Cost Breakdown

■	ICU	USD 10.36M	(45.1%)
■	Ward	USD 10.77M	(46.8%)
■	ED	USD 1.83M	(8.0%)

Key Takeaway

Despite representing only 7.1% of cases, ICU admissions accounted for 45.1% of total direct healthcare costs.

Distribution of Total Direct Healthcare Costs

These findings highlight the substantial clinical and economic burden of pediatric LRTIs in Saudi Arabia and reinforce the value of preventive strategies targeting severe RSV disease.

Almuqati, N. M., Al-Hindi, M. Y., Moussa, H. A., Alzahrani, S. H., Almuntashri, M. A., Al-Qurashi, M. A., Barayyan, M. O., & Bin-Sifran, S. M. (2026). Healthcare utilization and economic burden of pediatric lower respiratory tract infections across five tertiary hospitals in Saudi Arabia. Pediatric Reports, 18(3), 71. https://doi.org/10.3390/pediatric18030071

Healthcare Utilization and Economic Burden of Pediatric Lower Respiratory Tract Infections Across Five Tertiary Hospitals in Saudi Arabia