Does Healthcare Deliver? Results from the Patient‑Reported Indicator Surveys (PaRIS): Canada
Table of contents
The OECD Patient-Reported Indicator Surveys (PaRIS) is a groundbreaking initiative that fills a critical gap in health data by measuring the health outcomes and care experiences of people. This is an essential piece of information still lacking: the views of those directly concerned by health services – the patients – about their experience with the healthcare system and the outcomes as reported by them. By capturing the perspectives of over 107 000 people across 1 800 primary care practices in 19 countries, PaRIS provides an internationally comparable assessment of how outcomes and experiences of primary care users aged 45 years and older vary across countries and how healthcare systems deliver the care people with chronic conditions need.
As the global population of people living with chronic conditions continues to grow, the need for healthcare systems to adapt to their needs has never been more urgent. PaRIS plays a crucial role in informing this shift by offering data that supports the reorganisation of healthcare around the care experiences and health outcomes that matter most to people. Unlike disease‑specific assessments, PaRIS takes a broader approach, measuring how healthcare impacts people’s lives across various dimensions. This comprehensive perspective has the potential to revolutionise the way we assess the performance of healthcare systems on a global scale.
PaRIS findings emphasise the need for more people‑centred and co‑ordinated care, especially for the 80% of primary care users aged 45 years and older that live with at least one chronic condition and the 50% that live with multiple (two or more) chronic conditions. Targeted policies are essential to address inequalities, enhance care co‑ordination, and build trust in healthcare systems. Encouraging patient involvement in care decisions and fostering strong relationships with healthcare professionals can lead to better health outcomes, greater trust in the system, and increased confidence in managing their own health. At the same time, a well-staffed healthcare workforce and primary care practices organised around people’s needs are key to achieving improved patient outcomes and experiences.
This country note leverages the main findings of the publication, Does Healthcare Deliver: Results from the Patient-Reported Indicator Surveys (PaRIS), to provide a focused assessment for Canada. Drawing on the analysis of the ten key patient-reported outcome and experience measures used in the survey (Table 1), it explores findings in the Canadian context and compares them to the OECD PaRIS average. The OECD PaRIS average is the simple average of the 17 OECD member countries participating in PaRIS.
More than three‑quarters (77%) of people with chronic conditions in Canada report good physical health, as measured by physical function, pain, and fatigue. This is above the OECD PaRIS average of 70%.
Nearly three‑quarters (74%) of people with chronic conditions in Canada report positive well-being, which reflects mood, vitality, and fulfilment. This is slightly above the OECD PaRIS average of 71%.
Around nine in ten (90%) people with chronic conditions in Canada report good person-centred care, care focusing on patient’s needs, which is above the OECD PaRIS average of 87%.
Nearly three‑quarters (71%) of people with chronic conditions in Canada report good care co‑ordination, which is above the OECD PaRIS average of 59%.
More than three‑quarters (76%) of people with chronic conditions are managed in primary care practices that report being well-prepared to co‑ordinate care, which is higher than the OECD PaRIS average of 56%.
Most people (94%) with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is 11 percentage points higher than the OECD PaRIS average of 83%.
More than four out of five people (82%) with three or more chronic conditions in Canada report that their medication was reviewed by a healthcare professional over the past 12 months; this is 7 percentage points above the OECD PaRIS average of 75%.
Around 76% of people with chronic conditions in Canada receive enough support to manage their own health, above the OECD PaRIS average of 63%.
Around one‑third (27%) of people with chronic conditions reporting confidence in using health information from the internet, compared to the OECD PaRIS average of 19% (range of 5‑34%).
Around four out of five people (82%) with chronic conditions are managed in practices that can exchange medical records electronically, which exceeds the OECD PaRIS average of 57%.
In Canada people with chronic conditions have experiences of healthcare and health outcomes around the OECD PaRIS average (Chapter 2). This assessment is based on the 10 key patient-reported outcome measures (PROMs) – physical health, mental health, social functioning, well-being and general health and patient-reported experience measures (PREMs) – confidence to self-manage, experienced co‑ordination of care, experienced person-centred care, experienced quality of care and trust in healthcare system (Figure 1).
In Canada, people living with chronic conditions have a likelihood of achieving good health outcomes similar to the OECD PaRIS average (Figure 1).
More than three‑quarters (77%) of people with chronic conditions in Canada report good physical health, as measured by physical function, pain, and fatigue. This is significantly above the OECD PaRIS average of 70% but 5 percentage points lower than the highest-performing country (82%).
Nearly nine out of ten (87%) people with chronic conditions in Canada report good mental health -in terms of quality of life, emotional distress, and social health- and good social functioning, which measures how well people carry out their usual social activities and roles. For both indicators, this is above the OECD PaRIS average of 83% but 6 percentage points lower than the highest-performing country (93%).
Nearly three‑quarters (74%) of people with chronic conditions in Canada report positive well-being, which reflects mood, vitality, and fulfilment. This is slightly above the OECD PaRIS average of 71% and 6 percentage points below the highest-performing country (80%).
More than four out of five (83%) people with chronic conditions in Canada report good general health, which is significantly above the OECD PaRIS average of 66% but still 10 percentage points lower than the highest-performing country (93%).
In Canada, people living with chronic conditions are more likely to experience good of quality of care, and co‑ordination of care (Figure 1).
Nearly three out of five (59%) people with chronic conditions in Canada feel confident managing their own health, matching the OECD PaRIS average. However, this is 33 percentage points lower than the highest-performing country (92%).
Nearly three‑quarters (71%) of people with chronic conditions in Canada report good care co‑ordination, which is well above the OECD PaRIS average of 59%. Nevertheless, a 10 percentage point difference to the highest-performing country (81%).
Around 9 in 10 (90%) of people with chronic conditions in Canada report good person-centred care, care focusing on patient’s needs, which is above the OECD PaRIS average of 87% and 7 percentage points lower than the highest-performing country (97%).
More than nine out of ten (94%) people with chronic conditions in Canada report experiencing good quality of care, which is significantly above the OECD PaRIS average of 87% and only 3 percentage points below the highest-performing country (97%).
Nearly two‑thirds (61%) of people with chronic conditions in Canada trust their healthcare system, which is slightly below the OECD PaRIS average of 62%.
Source: See Chapter 2 for more details.
People living with multiple chronic conditions report lower levels of physical and mental health, well-being and social functioning compared to those who live with one chronic condition (Chapter 3). This pattern is consistent with the OECD PaRIS average, yet Canada scores above the OECD PaRIS average for social functioning, physical and mental health in people with three or more chronic conditions. Specifically:
In Canada, people with three or more chronic conditions are less likely to report better health compared to those with two chronic conditions. This pattern is consistent with other countries’ results.
People living with several chronic conditions in Canada have poorer physical health compared to those living with only one chronic condition with seven‑point difference, a pattern similar to the OECD PaRIS average. However, the physical health scores for people with one, two, or three or more chronic conditions in Canada are slightly higher than the OECD PaRIS average (Figure 2). For example, while the average physical health score of people with three or more chronic conditions is above the good-fair cutoff point (42) in Canada, the OECD PaRIS average is below the cutoff for this group.
Similarly, Canada performs better than the OECD PaRIS average regarding the mental health of people living with one, two, and three or more chronic conditions. People with multiple chronic conditions in Canada report poorer mental health than those with one chronic condition with about a five‑point difference, yet it remains above the OECD PaRIS average (Figure 3).
Like in other countries, people with multiple chronic conditions in Canada less often report good social functioning than people with one chronic condition (Figure 4). While 94% of people with one chronic condition in Canada have good social functioning, this goes down to 80% of people with three or more chronic conditions, which is above the OECD PaRIS average.
Primary care consultation features associated with higher levels of experienced quality care are related to time, both time‑scheduled for regular, follow-up consultations, and length of relationship with the same primary care professional (Chapter 3). The role of staff other than physicians supporting the management of people with chronic conditions also plays a role in improving healthcare delivery for people with multiple chronic conditions (Chapter 3). Systematic medication reviews in people with multiple chronic conditions can enhance medication safety and efficacy while also increasing experienced care co‑ordination.
Canada performs similar to the OECD PaRIS average in the following primary care features (Figure 5):
Two out of five people (41%) with two or more chronic conditions in Canada are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is close to the OECD PaRIS average of 47%.
In Canada, most people (94%) with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is 11 percentage points higher than the OECD PaRIS average of 83%.
More than four out of five people (82%) with three or more chronic conditions in Canada report that their medication was reviewed by a healthcare professional over the past 12 months; this is 7 percentage points above the OECD PaRIS average of 75%.
More than three out of five people with two or more chronic conditions (61%) in Canada report being with the same primary care professional for more than five years; this is around the OECD PaRIS average.
People‑centred care, healthcare systems addressing the needs of people, is an essential indicator of the quality and performance of healthcare systems and primary care practices (Chapter 4). PaRIS data show that a people‑centred approach that prioritise strong patient engagement and effective care co‑ordination, is associated with enhanced health outcomes and patient experiences. This approach is particularly beneficial in managing chronic conditions, as it empowers patients to actively participate in decisions about their health.
On several indicators of people‑centred care, Canada performs better than the OECD PaRIS average (Figure 6):
Around 76% of people with chronic conditions in Canada receive enough support to manage their own health, significantly above the OECD PaRIS average of 63%.
Canada shows a higher level of digital health literacy, with 27% of people with chronic conditions reporting confidence in using health information from the internet, compared to the OECD PaRIS average of 19% (range of 5‑34%).
More than three‑quarters (76%) of people with chronic conditions are managed in primary care practices that report being well-prepared to co‑ordinate care, which is significantly higher than the OECD PaRIS average of 56%.
Around 82% of people with chronic conditions are managed in practices that can exchange medical records electronically, which far exceeds the OECD PaRIS average of 57%.
These results reflect Canada’s robust primary care infrastructure and its strong emphasis on empowering patients with chronic conditions to manage their health effectively while leveraging digital health solutions.
Among people with chronic conditions, there are differences in well-being and trust in the healthcare systems across genders in Canada, both indicators being lower for women (Figure 7 and Figure 8).
The gender gap in well-being in Canada is smaller compared to the OECD PaRIS average (5 points). This gender gap mirrors results for other countries; however, Canada performs slightly better than the OECD PaRIS average in terms of well-being, particularly for women.
While about 68% of men with chronic conditions in Canada have trust in the healthcare system, this is the case for only 56% of women with chronic conditions. These results for trust are close to the OECD PaRIS average for men (67%) and women (58%). The gender gap in trust in Canada (12 percentage points) is larger than the OECD PaRIS average gap (9 percentage points).
As in other OECD countries, people with chronic conditions and higher incomes in Canada report higher well-being and trust in the healthcare system (Figure 9 and Figure 10):
Across OECD PaRIS countries, people with chronic conditions and higher incomes report better well-being than those with lower incomes (seven points). Canada well-being levels across income groups are similar to the OECD PaRIS average, although slightly higher for people with low income.
In Canada, among people living with chronic conditions, almost seven out of ten people (68%) with higher income trust the healthcare system, compared to 58% of people with lower income. The trust levels in the healthcare system across income groups are similar to the OECD PaRIS average for high (70%) and low (59%) income groups. The gap between high- and low-income groups in Canada is comparable to the OECD PaRIS average.
PaRIS at a glance
PaRIS contains information on patient-reported outcomes and experience measures as well as health behaviours and capabilities, sociodemographic characteristics from patients and primary care practice characteristics information from healthcare providers. The data collection took place in 2023‑24 and first results were released in the publication, Does Healthcare Deliver: Results from the Patient-Reported Indicator Surveys (PaRIS).
Results span 107 011 primary care users (aged 45 years and older) and 1 816 primary care practices in 19 countries: Australia, Belgium, Canada, Czechia, France, Greece, Iceland, Italy, Luxembourg, Netherlands, Norway, Portugal, Romania, Saudi Arabia, Slovenia, Spain, Switzerland, the United States and Wales (United Kingdom). All results in this country note are age-sex standardised to adjust for the different demographic profiles of the countries. In Figure 1, highest (lowest) represents the highest (lowest) values found for each indicator among 17 PaRIS countries. In Italy and the United States, eligibility criteria for patient participation differed from the guidelines, therefore, these countries are not included in this figure. For detailed information on national sampling procedures and other methodological details, see Chapter 7 of the report.
Results for Canada are based on 3 883 patients and 65 primary care practices. In Canada all patients from the registry of patients of participating practices were invited to participate in the survey. Practices were sampled by convenience sampling from groups of practices by province.
In Canada, primary care practices responded to the questionnaire online. Patients responded to the questionnaire online.
This work is published under the responsibility of the Secretary-General of the OECD. The opinions expressed and arguments employed herein do not necessarily reflect the official views of the Member countries of the OECD.
This document, as well as any data and map included herein, are without prejudice to the status of or sovereignty over any territory, to the delimitation of international frontiers and boundaries and to the name of any territory, city or area.
The full book is available in English: OECD (2025), Does Healthcare Deliver?: Results from the Patient-Reported Indicator Surveys (PaRIS), OECD Publishing, Paris, https://doi.org/10.1787/c8af05a5-en.
© OECD 2025
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