{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T15:53:42Z","timestamp":1772466822059,"version":"3.50.1"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: In Saudi Arabia, a high-income country with a publicly funded healthcare system, sickle cell disease (SCD) remains a major pediatric health challenge. This study aimed to identify factors associated with healthcare utilization, specifically inpatient (IP), outpatient (OP), and emergency department (ED) visits, among children with SCD in Saudi Arabia. (2) Methods: A retrospective observational study was conducted using data from the KAIMRC registry (2015-2023), including 450 children under 12 years old diagnosed with SCD. Negative binomial regression models were employed to analyze the annual average visits, accounting for clinical, demographic, and regional healthcare resource variables. (3) Results: Key predictors of IP visits included complication count, crisis episodes, and region (eastern, western, and southern regions had higher utilization than central). ED visits were positively associated with complications, crisis episodes, and hydroxyurea use, but negatively associated with bone marrow transplant receipt. OP visits increased with higher Charlson Comorbidity Index scores, age, and bone marrow transplant, but were lower in the eastern region. (4) Conclusions: These findings highlight the influence of clinical and regional factors even within an equitable, high-resource healthcare system.<\/jats:p>","DOI":"10.3390\/ijerph23030309","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T14:55:01Z","timestamp":1772463301000},"page":"309","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with Healthcare Utilization in Children with Sickle Cell Disease in Saudi Arabia"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4859-4952","authenticated-orcid":false,"given":"Daniya","family":"Sabrah","sequence":"first","affiliation":[{"name":"Department of Health Management and Systems Sciences, School of Public Health, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3796-8141","authenticated-orcid":false,"given":"Seyed M.","family":"Karimi","sequence":"additional","affiliation":[{"name":"Department of Health Management and Systems Sciences, School of Public Health, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6485-4641","authenticated-orcid":false,"given":"Bert","family":"Little","sequence":"additional","affiliation":[{"name":"Department of Health Management and Systems Sciences, School of Public Health, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1810-1961","authenticated-orcid":false,"given":"Demetra","family":"Antimisiaris","sequence":"additional","affiliation":[{"name":"Department of Health Management and Systems Sciences, School of Public Health, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-8370","authenticated-orcid":false,"given":"Danyah A.","family":"Aldailami","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh 93499, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7326-7847","authenticated-orcid":false,"given":"Ahmed","family":"Alabdrabalnabi","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh 93499, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3577-7994","authenticated-orcid":false,"given":"Fatima","family":"Aldarweesh","sequence":"additional","affiliation":[{"name":"Department of Health Management and Systems Sciences, School of Public Health, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102612","DOI":"10.1016\/j.bcmd.2021.102612","article-title":"Global geographic differences in healthcare utilization for sickle cell disease pain crises in the CASiRe cohort","volume":"92","author":"Strunk","year":"2021","journal-title":"Blood Cells Mol. 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