Does Healthcare Deliver? Results from the Patient‑Reported Indicator Surveys (PaRIS): Netherlands
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 the Netherlands. 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 Dutch 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.
Nearly three‑quarters (74%) of people with chronic conditions in the Netherlands report good physical health, as measured by physical function, pain, and fatigue. This is above the OECD PaRIS average of 70%.
More than four out of five (85%) people with chronic conditions in the Netherlands report good mental health, which refers to quality of life, emotional distress, and social health. This is above the OECD PaRIS average of 83% but around 10 percentage points lower than the highest-performing country (93%).
About nine out of ten (92%) people with chronic conditions in the Netherlands report experiencing good quality of care and person-centred care (90%), care focusing on patient’s needs. This is above the OECD PaRIS average of 87% for both measures.
Nearly one in ten people (11%) with two or more chronic conditions in the Netherlands are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is more than 36 percentage points lower compared to the OECD PaRIS average of 47%.
All 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 17 percentage points higher than the OECD PaRIS average of 83%.
Almost all (97%) of people with chronic conditions are managed in primary care practices that report being well-prepared to co‑ordinate care, which is far above the OECD PaRIS average of 56%. In addition, nearly all (99.9%) people with chronic conditions are managed in practices that can exchange medical records electronically, far exceeding the OECD PaRIS average of 57%. Yet, around half (49%) of people in the Netherlands report good care co‑ordination, which is below the OECD PaRIS average of 59%.
In the Netherlands people with chronic conditions more often have confidence in managing their health and trust in healthcare system compared to the OECD PaRIS average. Yet, people are less likely to experience good care co‑ordination. Health outcomes are better or comparable to 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 the Netherlands, people living with chronic conditions are more likely to have good health outcomes compared to other countries in PaRIS (Figure 1):
Nearly three‑quarters (74%) of people with chronic conditions in the Netherlands report good physical health, as measured by physical function, pain, and fatigue. This is above the OECD PaRIS average of 70% and 8 percentage points lower than the highest-performing country (82%).
More than four out of five (85%) people with chronic conditions in the Netherlands report good mental health, which refers to quality of life, emotional distress, and social health. A similar percentage (82%) report good social functioning, which measures how well people carry out their usual social activities and roles. These are slightly above the OECD PaRIS average of 83% but around 10 percentage points lower than the highest-performing country (93%).
Nearly four out of five (79%) people with chronic conditions in the Netherlands report positive well-being, which reflects mood, vitality, and fulfilment. This is well above the OECD PaRIS average of 71% and close to the highest-performing country (80%).
Nearly two‑thirds (64%) of people with chronic conditions in the Netherlands report good general health, which is close to the OECD PaRIS average of 66%, but the 29 percentage point difference with the highest-performing country (93%) reveals room for improvement.
In the Netherlands, people living with chronic conditions are more likely to be confident managing their own health and trusting the healthcare system compared to most other countries (Figure 1). However, only half the people report good co‑ordination of care:
More than three‑quarters (78%) of people with chronic conditions in the Netherlands feel confident managing their own health, which is significantly above the OECD PaRIS average of 59% but still 14 percentage points lower than the highest-performing country (92%).
Around half (49%) of people with chronic conditions in the Netherlands report good care co‑ordination, which is well below the OECD PaRIS average of 59% and 32 percentage points lower than the highest-performing country (81%).
Nine out of ten (90%) people with chronic conditions in the Netherlands report highly person-centred care, care focusing on patient’s needs, which is above the OECD PaRIS average of 87% and only 7 percentage points lower than the highest-performing country (97%).
More than nine out of ten (92%) people with chronic conditions in the Netherlands report experiencing good quality of care, which is above the OECD PaRIS average of 87% and only 5 percentage points lower than the highest-performing country (97%).
Nearly three‑quarters (71%) of people with chronic conditions in the Netherlands trust their healthcare system, which is well 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 or no chronic condition (Chapter 3). This pattern is consistent with the OECD PaRIS average and the Netherlands scores. Specifically:
In the Netherlands, 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 the Netherlands have poorer physical health compared to those living with one chronic condition with an eight‑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 the Netherlands are comparable to the OECD PaRIS average (Figure 2). For example, people with three or more chronic conditions in the Netherlands score below the good-fair cutoff point (42) for physical health, comparable to the OECD PaRIS average.
Netherlands 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 multiple chronic conditions in the Netherlands report poorer mental health than those with one chronic condition with a four‑point difference, slightly above the OECD PaRIS average (Figure 3).
Like in other countries, people with multiple chronic conditions less often report good social functioning than people with one chronic condition in the Netherlands (Figure 4). While 88% of people with one chronic condition in the Netherlands have good social functioning, this goes down to 71% of people with three or more chronic conditions, which is below the OECD PaRIS average (75%).
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.
The percentage of people with multiple chronic conditions in the Netherlands who are managed in practices where consultation times are scheduled for more than 15 minutes is lower than the OECD PaRIS average, yet the proportion of people that have been with the same healthcare professional for more than five years is above the OECD PaRIS average. Specifically:
Nearly one in ten people (11%) with two or more chronic conditions in the Netherlands are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is more than 36 percentage points lower compared to the OECD PaRIS average of 47% (Figure 5).
In the Netherlands, all 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 17 percentage points higher than the OECD PaRIS average of 83% (Figure 5).
More than half of the people (54%) with three or more chronic conditions in the Netherlands report that their medication was reviewed by a healthcare professional over the past 12 months (Figure 5); this is about 21 percentage points lower than the OECD PaRIS average of 75%.
Almost three out four people with two or more chronic conditions (73%) in the Netherlands report being with the same primary care professional for more than five years; this is 15 percentage points above 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, the Netherlands demonstrates strong performance compared to the OECD PaRIS average (Figure 6):
Around 54% of people with chronic conditions in the Netherlands receive enough support to manage their own health, which is below the OECD PaRIS average of 63%.
The Netherlands performs relatively well in digital health literacy, with 24% 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%).
A very high percentage (97%) of people with chronic conditions are managed in primary care practices that report being well-prepared to co‑ordinate care, which is far above the OECD PaRIS average of 56%.
Nearly all (99.9%) people with chronic conditions are managed in practices that can exchange medical records electronically, far exceeding the OECD PaRIS average of 57%.
These results highlight the Netherlands’ strong infrastructure for care co‑ordination and electronic medical record adoption, with notable success in digital health literacy, though patient support could be further enhanced.
There are differences in well-being and trust in the healthcare systems across genders in the Netherlands, both indicators being lower for women (Figure 7 and Figure 8).
The gender gap in well-being in the Netherlands is comparable to the OECD PaRIS average (5 points). This gender gap mirrors results for other countries. However, in the Netherlands both men and women score above the OECD PaRIS average on well-being.
While about 75% of men in the Netherlands have trust in the healthcare system, the percentage for women is lower 68%. However, trust levels are higher than the OECD PaRIS average for men (67%) and women (58%).
The gender gap in trust in the Netherlands (7 percentage points) is smaller than the OECD PaRIS average gap (9 percentage points).
As in other OECD countries, people with chronic conditions and higher income reports higher well-being and trust in the healthcare system (Figure 9 and Figure 10):
Across OECD PaRIS countries, people with higher incomes report about 13% better well-being than those with lower incomes. Netherlands levels are higher than the OECD PaRIS average in all income groups.
In the Netherlands, among people living with chronic conditions, almost eight out of ten people (79%) with higher income trust the healthcare system, compared to 68% of people with lower income. The trust levels in the healthcare system across income groups are much higher than the OECD PaRIS average for high (70%) and low (59%) income groups.
The gap in trust between high- and low-income groups in the Netherlands is comparable to the OECD PaRIS average of 11%.
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 from the Netherlands are based on 4 851 patients and 60 primary care practices. Patients were sampled by probability sampling from the National patient registry. Primary care practices were sampled by probability sampling from the National municipality healthcare provider registry.
In the Netherlands, 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.
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