Does Healthcare Deliver? Results from the Patient‑Reported Indicator Surveys (PaRIS): France
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 or 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 France. 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 French 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 two‑thirds (68%) of people with chronic conditions in France report good physical health, as measured by physical function, pain, and fatigue. This is slightly below the OECD PaRIS average of 70%.
Two-thirds (67%) of people with chronic conditions in France report positive well-being, measured in terms of mood, vitality, and fulfilment. This is slightly below the OECD PaRIS average of 71%.
Nearly two‑thirds (61%) of people with chronic conditions in France report good care co‑ordination, slightly above the OECD PaRIS average of 59%.
Almost all people with chronic conditions in France report good person-centred care (92%) and experiencing good quality of care (91%) which is above the OECD PaRIS average around 87%.
More than half (54%) of people with two or more chronic conditions in France are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is a 7 percentage points higher compared to the OECD PaRIS average of 47%.
In France, two out of five people (42%) with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is 41 percentage points lower than the OECD PaRIS average of 83%.
Only 28% of patients are managed in primary care practices that report being well-prepared to co‑ordinate care, which is lower than the OECD PaRIS average of 56%.
Around 69% of patients are managed in practices that can exchange medical records electronically, which is above the OECD PaRIS average of 57%.
About one‑third (31%) of people with chronic conditions report confidence in using health information from the internet, compared to the OECD PaRIS average of 19% (range of 5‑34%).
In France people with chronic conditions in general have better experiences of healthcare and better health outcomes, compared to other PaRIS countries. 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).
While people living with chronic conditions in France are more likely to have good social functioning and general health than most countries in PaRIS, percentage of people having favourable physical, mental and well-being is close to the OECD PaRIS average (Figure 1):
More than two‑thirds (68%) of people with chronic conditions in France report good physical health, as measured by physical function, pain, and fatigue. This is slightly below the OECD PaRIS average of 70% and significantly lower than the highest-performing country (82%).
Nearly nine out of ten (87%) people with chronic conditions in France report good mental health, which refers to quality of life, emotional distress, and social health. This is above the OECD PaRIS average of 83% and only 6 percentage points lower than the highest-performing country (93%).
Nine out of ten (91%) people with chronic conditions in France report good social functioning, which measures how well people carry out their usual social activities and roles. This is well above the OECD PaRIS average of 83% and close to the highest-performing country (93%).
Two-thirds (67%) of people with chronic conditions in France report positive well-being, measured in terms of mood, vitality, and fulfilment. This is slightly below the OECD PaRIS average of 71%, but with a 13 percentage point difference with highest-performing country (80%).
Three‑quarters (76%) of people with chronic conditions in France report good general health, which is significantly above the OECD PaRIS average of 66% and 37 percentage points higher than the lowest-performing country (39%).
In France, people living with chronic conditions are more likely to be confident managing their own health, report good person-centred care, care focusing on patient’s needs, and experience good quality of care (Figure 1):
Almost all people with chronic conditions in France (92%) feel confident managing their own health, this is the highest percentage among PaRIS participants and is significantly above the OECD PaRIS average of 59%.
Nearly two‑thirds (61%) of people with chronic conditions in France report good care co‑ordination, slightly above the OECD PaRIS average of 59% but the 20 percentage point difference with the highest-performing country (81%) shows room for improvement.
Almost all people with chronic conditions in France report good person-centred care (92%) and experiencing good quality of care (91%) which is above the OECD PaRIS average around 87% and close to the highest-performing country in both indicators (97%).
Nearly two‑thirds (61%) of people with chronic conditions in France trust their healthcare system, slightly below the OECD PaRIS average of 62% and 28 percentage points lower than the highest-performing country (89%).
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 and France scores. Specifically:
In France, 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 multiple chronic conditions in France have poorer physical health compared to those living with one chronic condition with a seven‑point difference, a pattern consistent with the PaRIS average. However, the physical health scores for people with one, two, or three or more chronic conditions in France are slightly lower than the OECD PaRIS average (Figure 2). In France people with three or more chronic conditions have an average physical health score below the good-fair cutoff point (42), similar to the OECD PaRIS average.
Similarly, France performs slightly below 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 France report poorer mental health than those with one chronic condition with a 4‑point difference, similar to the pattern in OECD PaRIS average (Figure 3).
People with multiple chronic conditions less often report good social functioning than people with one chronic condition in France, yet there is a smaller gap in France (10 percentage points) compared to the OECD PaRIS average (17 percentage points) (Figure 4). While 95% of people with one chronic condition in France report good social functioning, this goes down to 85% of people with three or more chronic conditions, nevertheless it remains above the OECD PaRIS average also for this group.
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.
France performs close to the OECD PaRIS average in most of these primary care features, except for the proportion of people who are managed in practices where non-physician staff is involved in chronic disease management, which is lower than OECD PaRIS average:
More than half (54%) of the people with two or more chronic conditions in France are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is 7 percentage points higher compared to the OECD PaRIS average of 47% (Figure 5).
In France, two out of five (42%) people with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is 41 percentage points lower than the OECD PaRIS average of 83%.
About four out of five (77%) people with three or more chronic conditions in France report that their medication was reviewed by a healthcare professional over the past 12 months (Figure 5); this is close to the OECD PaRIS average of 75%.
Three out of five (64%) of the people with two or more chronic conditions in France report being with the same primary care professional for more than five years; this is similar to the OECD PaRIS average (58%) (Figure 5).
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, France demonstrates mixed performance compared to the OECD PaRIS average (Figure 6):
Around 62% of patients with chronic conditions in France receive enough support to manage their own health, slightly below the OECD PaRIS average of 63%.
France significantly outperforms in digital health literacy, with 31% 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%).
Only 28% of patients are managed in primary care practices that report being well-prepared to co‑ordinate care, which is significantly lower than the OECD PaRIS average of 56%.
Around 69% of patients are managed in practices that can exchange medical records electronically, which is above the OECD PaRIS average of 57%.
These results highlight France’s strengths in digital health literacy and electronic medical record adoption but reveal important challenges in providing adequate support for care co‑ordination in primary care settings.
Among people with chronic conditions, there are differences in well-being and trust in the healthcare system between genders in France, both indicators being lower for women (Figure 7 and Figure 8).
The gender gap in well-being in France is small compared to the OECD PaRIS average (5 points). This gender gap mirrors results for other countries; however, France performs below the OECD PaRIS average in terms of well-being for both men and women.
While 67% of men with chronic conditions in France have trust in the healthcare system, only 56% of women with chronic conditions have trust in the healthcare system. These results for trust are closely aligned to the OECD PaRIS average for men (67%) and women (58%). The gender gap in trust in France (11 percentage points) is similar to the OECD PaRIS average gap (9 percentage points).
As in other OECD countries, people with chronic conditions and higher incomes 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 difference). France’s well-being levels across income groups are comparable to the OECD PaRIS average.
In France, two‑third (66%) of people living with chronic conditions with higher incomes trust the healthcare system, compared to 58% of people with lower incomes. These trust levels are lower than the OECD PaRIS average for high income (70%) and are similar to the OECD PaRIS average for low-income groups (59%).
The gap between high- and low-income groups in France is lower than the 19% OECD PaRIS average and is not statistically significant.
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 France are based on 12 242 patients and 150 primary care practices. In France patients were sampled by probability sampling from the health insurance registry. Primary care practices were sampled by probability sampling from the National directory of healthcare professionals.
In France, primary care practices responded to the questionnaire online. Patients responded to the questionnaire online, by telephone and via paper-and-pencil surveys.
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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