Impact of the Saudi Health Sector Transformation Program (SHSTP): A Mixed-Methods Evaluation of Patient-Centered Care and Digital Health Adoption

<b>Background:</b> As part of Vision 2030, the Saudi Health Sector Transformation Program (SHSTP) introduced hospital clustering and digital health to strengthen patient-centered care. However, limited empirical evidence exists on its real-world impact. SHSTP represents one of the first large-scale digital integration reforms in the Gulf region, aligning with international frameworks such as the WHO Integrated People-Centred Health Services (IPCHS) and the Wagner Chronic Care Model. This study therefore contributes policy-relevant evidence on how national digital health reforms translate into measurable improvements in care coordination and patient experience. <b>Methods:</b> A convergent mixed-methods study was conducted across two regions (Mecca and Eastern Province) and four public hospitals (two clustered, two non-clustered) from 2016 to 2024. Quantitative indicators included patient satisfaction, Patient-Centered Care Index (PCCI), follow-up compliance, digital engagement (telemedicine, Sehat app/EMR), operational efficiency, and readmissions. Analyses used <i>t</i>-tests, ANOVA, and multivariable regression. Qualitative data from 53 semi-structured interviews (patients and physicians) were thematically analyzed and integrated with quantitative results through triangulation. <b>Results:</b> Clustered hospitals showed higher patient satisfaction (87.6% vs. 75.0%), stronger care coordination (PCCI: 89.4 vs. 69.7; <i>p</i> < 0.001), and better follow-up compliance (83.6% vs. 71.2%; <i>p</i> = 0.006). Digital engagement was greater (telemedicine 0.53 vs. 0.30; Sehat app 0.55 vs. 0.26; both <i>p</i> < 0.05). Regression identified hospital clustering (β = 12.49; <i>p</i> = 0.022), physician role (β = 19.92; <i>p</i> < 0.001), and digital literacy (β = 4.03; <i>p</i> = 0.047) as significant predictors of care coordination. Qualitative findings supported these results but highlighted challenges with digital literacy and workforce stability. <b>Conclusions:</b> SHSTP clustering improves patient experiences, digital engagement, and operational performance in chronic care. Sustained progress requires investment in digital literacy, workforce development, and change management. Broader longitudinal evaluation is warranted to confirm scalability and system-wide effects. These results extend the global evidence base on health system transformation by illustrating how digital and structural integration can operationalize patient-centered care in emerging-economy settings.