From vision to value: a mixed methods evaluation of patient-centered care in Saudi Arabian primary healthcare centers

The transformation of Saudi Arabia’s healthcare system under Vision 2030 emphasizes the importance of primary healthcare (PHC) centers and patient-centered care (PCC). Despite national reforms, limited research has assessed the extent to which PHC practices have adopted PCC principles. This study evaluated the impact and current status of the implementation of PCC across PHC centers in the Eastern Health Cluster of Saudi Arabia using the Patient-Centered Medical Home Assessment (PCMH-A) tool. A convergent parallel mixed-methods design was employed. Quantitative data were collected from 59 PHC centers across three health networks using the PCMH-A tool, which evaluates the implementation of PCC across seven domains. Simultaneously, qualitative data were gathered through open-ended responses embedded in the tool and analyzed thematically using Braun and Clarke’s approach. PCMH-A scores indicated moderate PCC implementation across all networks. The highest performing domain was quality improvement strategy (mean = 7.48), while patient-centered interactions scored the lowest (mean = 5.08). Comparison across networks showed that Network C consistently outperformed the others, supported by its structured leadership approach, stronger team-based care practices, and active community engagement initiatives. The qualitative findings helped explain these results. The participants reported several barriers to PCC, including centralized governance, limited access to services, poor care coordination, and low patient engagement. They also noted strengths such as improvements driven by accreditation and the use of health technology. Many of the barriers—such as limited resources, cultural factors, and uneven policy implementation—contributed to differences in PCC performance across networks. Despite promising initiatives, significant gaps remain in PCC delivery in Saudi PHC centers, particularly in access, continuity, and patient involvement. Policy efforts should focus on decentralizing authority, investing in digital integration, and promoting culturally responsive practices. Enhancing these areas is essential for achieving Vision 2030’s goals and building an equitable, person-centered healthcare system. Not applicable.