Patients’ perspectives on primary healthcare reforms in Saudi Arabia: a qualitative focus group study

Abstract Background In Saudi Arabia, the Vision 2030 health reform agenda aims to transform primary health care (PHC) through service expansion and digital innovation. However, limited research has explored how patients perceive these changes. Objective To explore patient experiences of PHC reforms in Saudi Arabia across the domains of accessibility, continuity, coordination, and comprehensiveness. Methods A qualitative study was conducted using 11 focus groups with 44 patients across four regions of Saudi Arabia. Participants were recruited through purposive sampling. Thematic analysis, guided by both inductive and deductive coding, was used to explore patient experiences. Results Participants described mixed experiences across the four PHC domains. Within the accessibility domain, systems such as ‘Mawid: My Appointment’ and ‘Wasfaty: My Prescription’ improved appointment booking and medication access for many patients; however, older adults and individuals with limited digital literacy or poor internet connectivity experienced additional barriers. Participants also reported limited parking, restricted appointment flexibility, and long travel distances to obtain medications in some areas. In the continuity domain, participants valued seeing the same physician over time and associated continuity with trust and familiarity. Frequent physician turnover weakened relational continuity, although electronic medical records supported informational continuity across providers. In the coordination domain, participants reported that ‘Ehalati: My Referral’ improved referral speed and access to specialist care, but communication gaps between primary and secondary care providers remained common. Regarding comprehensiveness, participants acknowledged improvements in laboratory, X-ray, dental, and mental health services within PHCCs. Nevertheless, long waiting times and limited appointments remained major concerns in dental care, while mental health services were perceived as less visible and inconsistently available. Conclusion Recent PHC reforms in Saudi Arabia appear to have improved several aspects of primary care delivery. However, patients’ experiences suggest that successful PHC transformation requires not only structural and technological change, but also sustained attention to equitable access, patient-provider relationships, and integration of care across services.