Parental perspectives on pediatric emergency department use in Riyadh, Saudi Arabia: a cross-sectional study

Objective: This study aimed to examine the factors influencing parental decision-making in pediatric emergency department (ED) visits for non-urgent conditions, identify gaps in primary healthcare centers (PHCs) utilization, and assess opportunities to redirect care toward more appropriate settings. Methods: This cross-sectional study was conducted between October 2023 and April 2024 among parents or guardians of pediatric patients presenting at the Pediatric ED of King Fahad Medical City, Riyadh, Saudi Arabia, for non-urgent conditions. Urgent cases were defined as those triaged as Canadian Triage and Acuity Scale (CTAS) system levels 1-2, while non-urgent cases corresponded to CTAS levels 3-4. Results: Out of a total of 1,040 participants, most children were aged 1-5 years (n = 456, 43.89%), followed by 6-10 years (n = 236, 22.71%). Fever was the main reason for presentation to the ED (n = 524, 50.43%), followed by gastrointestinal symptoms (n = 186, 17.9%). The most common frequency of ED visits in the preceding year was two visits (n = 327, 31.44%). Most participants (n = 698, 67.08%) did not visit a PHC to address their current conditions. Further, 67% did not seek PHC, and 69% lacked a regular pediatrician. The primary driver was perceived to have a shorter wait time (36%). Findings highlight barriers to PHC access and underscore the need for targeted interventions. Conclusion: This study highlighted the factors driving pediatric ED use in Riyadh, Saudi Arabia. Limited access to primary care services, along with a lack of trust and awareness, emerged as significant barriers to appropriate service utilization.