Measuring patient experience of primary care and capturing patients’ perceptions of the primary care reforms in Saudi Arabia

Abstract

Background: Primary care (PC) is the backbone of most health systems around the world. In Saudi Arabia, the health system is reforming as part of the country Vision 2030 and Health Transformation Strategy. One of the principal objectives of this reform is to build a new, strong PC system to attract patients and enhance preventive care. PC will play a significant role within this transformation strategy, which calls for PC improvement in terms of facilities, services, and technology. The patient is a primary recipient and profoundly impacted by these reforms. Therefore, patient experience is essential for guiding and improving the health reform plans in Saudi primary care. Aim: This study aims to assess patient experience with PC and capture patients’ perceptions of the PC reforms in Saudi Arabia. Methods: Three pieces of work were conducted sequentially and integrated to answer the research question and achieve the study's objectives. The first was a scoping review conducted in January 2021 and updated in September 2023 that reviewed the existing instruments designed to measure patient experience in primary care globally for identifying the main domains of patients’ experiences with PC, and factors affecting those experiences. Eighty five papers were extracted and synthesised. The second piece of work was a series of eleven focus groups conducted in January/February 2022 with 44 PC patients to develop an in-depth understanding of the key issues related to PC reform in Saudi Arabia. The final piece of work was the development and implementation of a patient survey to measure patient experience with primary care and capture patients’ perceptions of the primary care reform in Saudi Arabia. The survey then distributed to PC patients. Five hundred and ninety nine individuals responded between December 2022 and February 2023. 2 Findings: Overall, there was a positive experience of accessibility to Primary Care Centres (PCCs) in Saudi Arabia. The majority of respondents expressed positive continuity of care, as they were able to receive care from their preferred primary care clinician, albeit with less continuity in their relationship with the same physician. Regarding coordination, the general quality of referrals to other healthcare providers seems to be commendable. Nevertheless, there is room for improvement in the feedback provided by other healthcare providers to PCC's physicians. Moreover, patients perceive the comprehensiveness of services provided to them in a positive manner, whereas the availability of services received a comparatively less positive rating from the respondents. The digital appointment system, known as Mawid, and the Wasfaty platform appear to be functioning effectively, resulting in a positive outcome. Two areas that warrant further attention are dental services and digital literacy, specifically in regards to Mawid. Conclusion: The study indicates that overall patient have positive experiences of primary care centres in Saudi Arabia but key areas for improvement remain. The methods developed and findings can inform future monitoring of patient experience as part of ongoing healthcare reforms.