Determinants of patient cycle time in primary healthcare: a large-scale retrospective study from Saudi Arabia

Patient cycle time is a useful operational metric for assessing the clinical encounter pathway in primary healthcare settings. Prolonged cycle times may reflect delays within the consultation process and may affect patient experience and clinic flow.

This study aims to evaluate patient cycle time at a large Family and Community Medical Centre in the Eastern Province of Saudi Arabia and to identify the demographic, clinical, and operational factors associated with variations in cycle time.

A retrospective analytical chart review was conducted using electronic health record data for all visits to FCMC over a 1-year period in 2025 (n = 52,611). Cycle time was defined as the duration from patient check-in to the closure of the physician encounter. Sociodemographic variables, visit characteristics, clinic type, seasonality, and diagnostic categories were analysed. Multivariable linear regression was performed to identify predictors of cycle time.

The median cycle time was 20 min (interquartile range: 20-21). Longer cycle times were significantly associated with visits to urgent care and chronic disease clinics, Saudi nationality, autumn visits, and acute diagnoses, including upper respiratory, gastrointestinal, musculoskeletal, neurological, and dermatological conditions. Shorter cycle times were observed for preventive care and diabetes-related visits. Increasing age was independently associated with shorter cycle time, while sex was not a significant predictor.

Cycle time at this primary healthcare centre was relatively short compared with national and international benchmarks. However, it varied by clinic type, diagnosis, season, and patient characteristics. Targeted operational interventions focusing on urgent care services, seasonal demand, and acute presentations may help optimize the clinical consultation pathway.