Preventable Hospitalization and Primary Healthcare Visits Among Hypertensive Patients in Makkah City

<b>Background:</b> Hypertension-preventable hospitalizations are used internationally as indicators of primary healthcare centers (PHCs) performance. The Ministry of Health (MoH) in Saudi Arabia has recently implemented several programs to strengthen PHCs and reduce avoidable admissions. This study aimed to observe recent trends in healthcare utilization among hypertensive patients in Makkah City. <b>Methods:</b> A retrospective comparative time-trend analysis was conducted using aggregated monthly counts from individual-level records collected by the Makkah Health Cluster between January 2023 and May 2024. Data from 43 PHCs and all public hospitals were analyzed using segmented Poisson regression based on the AHRQ Prevention Quality Indicator #07 (PQI-07) for hypertension. Models included demographic covariates (age, sex, nationality) and a dummy variable to adjust for the Eid holiday period. Rates were calculated per 100,000 adults. <b>Results:</b> A total of 42,743 hypertension-related encounters were identified, including 2895 preventable hospitalizations and 39,848 PHC visits. Monthly analyses showed a 5.7% decline in preventable hospitalizations (<i>IRR</i> = 0.943; <i>p</i> < 0.001) and a 1.5% increase in PHC visits (<i>IRR</i> = 1.015; <i>p</i> < 0.001). Reductions were most pronounced among adults ≥ 65 years. Non-Saudis were significantly less likely to attend PHCs, reflecting public-sector eligibility differences. <b>Conclusions:</b> After controlling for Eid-related seasonal variation, the results indicate a favorable shift toward outpatient hypertension management in Makkah City. These findings align with Saudi Vision 2030 objectives of strengthening PHC and reducing preventable hospital burden. Further multi-regional studies integrating private-sector data are warranted to confirm national trends.