Does Healthcare Deliver? Results from the Patient‑Reported Indicator Surveys (PaRIS): Luxembourg
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 Luxembourg. 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 context of Luxembourg 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 seven out of ten people (72%) with chronic conditions in Luxembourg report good physical health, as measured by physical function, pain, and fatigue. This is above the OECD PaRIS average of 70%.
Nearly nine out of ten (86%) people with chronic conditions in Luxembourg report good mental health – which refers to quality of life, emotional distress, above the OECD PaRIS average of 83%.
Nine out of ten people (91%) people with chronic conditions in Luxembourg report a high level of person-centred care, care focusing on patient’s needs, which is above the OECD PaRIS average of 87%.
Nearly two‑thirds (66%) of people with chronic conditions in Luxembourg trust their healthcare system, which is above the OECD PaRIS average of 62%.
More than half (56%) of people with chronic conditions in Luxembourg feel confident managing their own health, which is below the OECD PaRIS average of 59%.
Only 11% of people with chronic conditions in Luxembourg feel confident in using health information from the internet, compared to the OECD PaRIS average of 19% (range of 5‑34%).
In Luxembourg, about one out of five people (18%) with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is lower than the OECD PaRIS average of 83%.
Only 18% of people with chronic conditions are managed in practices that can exchange medical records electronically, below the OECD PaRIS average of 57%.
People with chronic conditions in Luxembourg are more likely to experience good quality of care compared to the OECD PaRIS average. Scores on other experiences of healthcare and health outcomes are mostly close to or slightly above the OECD PaRIS average. 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 (Table 1).
In Luxembourg, people living with chronic conditions are more likely to have good health outcomes compared to most other countries in PaRIS (Figure 1):
More than seven out of ten (72%) people with chronic conditions in Luxembourg report good physical health, as measured by physical function, pain, and fatigue. This is slightly above the OECD PaRIS average of 70% but 10 percentage points lower than the highest-performing country (82%).
Nearly nine out of ten (86%) people with chronic conditions in Luxembourg report good mental health – which refers to quality of life, emotional distress, and social health – and social functioning – which measures how well people carry out their usual social activities and roles. This is above the OECD PaRIS average of 83% and 7 percentage points lower than the highest-performing country for both indicators (93%).
71% of people with chronic conditions in Luxembourg report positive well-being, which reflects mood, vitality, and fulfilment. This matches the OECD PaRIS average and is 9 percentage points below the highest-performing country (80%).
71% of people with chronic conditions in Luxembourg report good general health, which is above the OECD PaRIS average of 66% but 22 percentage points lower than the highest-performing country (93%).
In Luxembourg, people living with chronic conditions are significantly more likely to have good experiences of quality of care than in other countries, while experiencing positive confidence in self- management, co‑ordination, person – centred and trust are all close to the OECD PaRIS average (Figure 1).
More than half (56%) of people with chronic conditions in Luxembourg feel confident managing their own health, which is slightly below the OECD PaRIS average of 59% and 36 percentage points lower than the highest-performing country (92%).
Nearly two‑thirds (63%) of people with chronic conditions in Luxembourg report good care co‑ordination, which is above the OECD PaRIS average of 59% but 18 percentage points below the highest-performing country (81%).
Nine out of ten people (91%) people with chronic conditions in Luxembourg report a high level of person-centred care, care focusing on patient’s needs, which is above the OECD PaRIS average of 87% and only 6 percentage points lower than the highest-performing country (97%).
More than nine out of ten (93%) people with chronic conditions in Luxembourg report experiencing good quality of care, which is significantly above the OECD PaRIS average of 87% and only 4 percentage points lower than the highest-performing country (97%).
Nearly two‑thirds (66%) of people with chronic conditions in Luxembourg trust their healthcare system, which is slightly above 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 most other countries. Specifically:
In Luxembourg, 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 Luxembourg have poorer physical health compared to those living with one chronic condition with a seven‑point difference, a pattern consistent with the OECD PaRIS average. The physical health scores for people with one, two, or three or more chronic conditions in Luxembourg are comparable to the OECD PaRIS average (Figure 2). For example, people with three or more chronic conditions in Luxembourg score on average below the good-fair cut-off point (42) for physical health, similar to the OECD PaRIS average.
Similarly, Luxembourg performs comparable to the OECD PaRIS average regarding the mental health of people living with one, two, and three or more chronic conditions. People with three or more chronic conditions in Luxembourg report poorer mental health than those with one chronic condition with a four‑point difference; this represents comparable difference between the groups compared to the OECD PaRIS average (five‑point difference) (Figure 3).
Like in other countries, people in Luxembourg with multiple chronic conditions less often report good social functioning than people with one chronic condition (Figure 4). While 92% of people with one chronic condition in Luxembourg have good social functioning, this goes down to 77% of people with three or more chronic conditions, which is slightly 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 and 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.
Luxembourg performs at an average level in terms of primary care consultation features compared to the OECD PaRIS average, except for a lower-than-average proportion of people managed in primary care practices with non-physician staff involved in chronic disease management (Figure 5):
About three out of five people (57%) with two or more chronic conditions in Luxembourg are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is more than 10 percentage points higher compared to the OECD PaRIS average of 47%.
Almost one out of five people (18%) in Luxembourg with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is 65 percentage points lower than the OECD PaRIS average of 83%.
More than three out of four people (76%) with three or more chronic conditions in Luxembourg report that their medication was reviewed by a healthcare professional over the past 12 months (Figure 5); this is similar to the OECD PaRIS average of 75%.
More than three out of five people with two or more chronic conditions (63%) in Luxembourg report being with the same primary care professional for more than five years; this represents more than 5 percentage points above the OECD PaRIS average (58%).
People‑centred care, meaning that healthcare addresses the needs of people, is an essential indicator of the quality and performance of healthcare systems and healthcare professionals (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, Luxembourg demonstrates a mixed performance compared to the OECD PaRIS average (Figure 6):
68% of people with chronic conditions in Luxembourg receive enough support to manage their own health, which is above the OECD PaRIS average of 63%.
11% of people with chronic conditions report having confidence in using health information from the internet, this is low compared to the OECD PaRIS average of 19% (range of 5‑34%).
A slightly higher proportion (59%) of people with chronic conditions are managed in primary care practices that report being well-prepared to co‑ordinate care, compared to the OECD PaRIS average of 56%.
However, only 18% of people with chronic conditions are managed in practices that can exchange medical records electronically, significantly below the OECD PaRIS average of 57%.
These results highlight Luxembourg’s strengths in care co‑ordination and patient support but also reveal areas for improvement in digital health literacy and the adoption of electronic medical record systems in primary care settings.
There are differences in well-being and trust in the healthcare systems across genders in Luxembourg, both indicators being generally lower for women (Figure 7 and Figure 8).
The gender gap in well-being in Luxembourg is the smallest among the OECD PaRIS countries. This gender gap mirrors results for other countries but is not statistically significant. Luxembourg performs similar to the OECD PaRIS average in terms of well-being for men and women.
While about 73% of men in Luxembourg have trust in the healthcare system, only 58% of women have trust in healthcare system. These trust levels are higher than the OECD PaRIS average for men (67%) and similar for women (58%).
The gender gap in trust in Luxembourg (15 percentage points) is the largest among the OECD PaRIS countries (average difference of 9 percentage points).
Similar to other OECD countries, people with chronic conditions and higher income report higher well-being and trust in the healthcare system (Figure 9 and Figure 10):
Across OECD PaRIS countries, people with higher incomes report 6 points higher well-being than those with lower incomes. Luxembourg well-being levels across income groups are comparable to the OECD PaRIS average (7 point difference).
In Luxembourg, among people living with chronic conditions, seven out of ten people (74%) with higher income trust the healthcare system, compared to 63% of people with lower income. The trust levels in the healthcare system across income groups are higher than the OECD PaRIS average for high (70%) and low (59%) income groups.
There is a 10 percentage point difference in trust between the high- and low-income groups in Luxembourg, similar to the OECD PaRIS average (11 percentage point difference).
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 Luxembourg are based on 1 590 patients and 52 primary care practices. Patients were sampled by probability sampling from the Calculus patient dataset. All primary care practices from the Calculus healthcare provider dataset were invited to participate in the survey.
In Luxembourg, primary care practices responded to the questionnaire online. Patients responded to the questionnaire online 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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