Does Healthcare Deliver? Results from the Patient‑Reported Indicator Surveys (PaRIS): Norway
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 Norway. 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 Norwegian 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.
Three out of four (75%) people with chronic conditions in Norway report good physical health, as measured by physical function, pain, and fatigue. This is slightly above the OECD PaRIS average of 70%.
Four out of five (83%) people with chronic conditions in Norway report good mental health, which refers to quality of life, emotional distress, and social health. This matches the OECD PaRIS average.
Around half of people with chronic conditions in Norway feel confident managing their own health (47%) and experience good care co‑ordination (51%). This is below the OECD PaRIS average of 59%. Around 60% of people with chronic conditions in Norway receive enough support to manage their own health, slightly below the OECD PaRIS average of 63%.
Almost seven out of ten (68%) people with chronic conditions with three or more chronic conditions in Norway report that their medication was reviewed by a healthcare professional over the past 12 months; this is below the OECD PaRIS average of 75%.
More than nine out of ten (92%) people with chronic conditions in Norway report experiencing good quality of care, above the OECD PaRIS average of 87%.
More than four out of five (87%) people with chronic conditions with two or more chronic conditions in Norway are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is almost 40 percentage points higher compared to the OECD PaRIS average.
Nearly all people with chronic conditions are managed in practices that can exchange medical records electronically, far exceeding the OECD PaRIS average of 57%.
In Norway people with chronic conditions have better experiences of healthcare, compared to other PaRIS countries. Health outcomes are 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 Norway, the likelihood of achieving good health outcomes for people with chronic conditions is slightly better than the OECD PaRIS average (Figure 1).
Three out of four (75%) people with chronic conditions in Norway report good physical health, as measured by physical function, pain, and fatigue. This is slightly above the OECD PaRIS average of 70% and 7 percentage points lower than the highest-performing country (82%).
Four out of five (83%) people with chronic conditions in Norway report good mental health, which refers to quality of life, emotional distress, and social health. This matches the OECD PaRIS average. There is a 10 percentage point difference with the highest-performing country (93%).
Four out of five (80%) people with chronic conditions in Norway report good social functioning, which measures how well people carry out their usual social activities and roles. This is slightly below the OECD PaRIS average of 83% and 13 percentage points lower than the highest-performing country (93%).
More than three‑quarters (76%) of people with chronic conditions report positive well-being, which captures mood, vitality, and fulfilment. This is above the OECD PaRIS average of 71% and only 4 percentage points below the highest-performing country (80%).
Nearly two‑thirds (63%) of people with chronic conditions in Norway report good general health, which is just below the OECD PaRIS average of 66% and 30 percentage points lower than the highest-performing country (93%).
In Norway, people living with chronic conditions are more likely to trust their healthcare system compared to most other countries in PaRIS, conversely, there is room for improvement in terms of confidence in self-management and care co‑ordination (Figure 1).
Around half of people with chronic conditions in Norway feel confident managing their own health (47%) and experience good care co‑ordination (51%). This is below the OECD PaRIS average of 59% and has a 45 and 30 percentage point difference with the highest-performing country (92% and 81%, respectively).
Nearly nine out of ten (87%) people with chronic conditions in Norway report highly person-centred care, slightly above the OECD PaRIS average of 87% but still 10 percentage points below the highest-performing country (97%).
More than nine out of ten (92%) people with chronic conditions in Norway report experiencing good quality of care, above the OECD PaRIS average of 87% and 5 percentage points below the highest-performing country (97%).
Nearly three‑quarters (73%) of people with chronic conditions in Norway trust their healthcare system, which is 11 percentage points 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 the OECD PaRIS average and Norway scores. Specifically:
In Norway, people with three or more chronic conditions are less likely to report better health compared to those with two chronic conditions. This pattern, consistent with other countries’ results, underscores the compounded health burdens experienced by people with multiple chronic conditions, emphasising the escalating toll that each additional chronic condition takes on their health and well-being.
People living with several chronic conditions in Norway 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 Norway are similar to the OECD PaRIS average (Figure 2). For example, people with three or more chronic conditions in Norway report physical health scores below the good-fair cutoff point (42), similar to the OECD PaRIS average.
Similarly, Norway performs similar 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 Norway report poorer mental health than those with one chronic condition with a five‑point difference, similar to the OECD PaRIS average (Figure 3).
People in Norway with multiple chronic conditions less often report good social functioning than people with one chronic condition (Figure 4). While 88% of people with one chronic condition in Norway have good social functioning, this goes down to 67% of people with three or more chronic conditions, which is 8 percentage points 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 duration 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.
Norway performs at an average level for three of the four primary care features assessed, with a higher-than-average proportion of people managed in primary care practices that offer regular consultation times of more than 15 minutes (Figure 5):
More than four out of five people (87%) with two or more chronic conditions in Norway are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is almost 40 percentage points higher compared to the OECD PaRIS average.
In Norway, three out of four people (75%) with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is 8 percentage points lower than the OECD PaRIS average of 83%.
Almost seven out of ten people (68%) with three or more chronic conditions in Norway report that their medication was reviewed by a healthcare professional over the past 12 months; this is about 7 percentage points below the OECD PaRIS average of 75%.
Almost six out of ten people with two or more chronic conditions (58%) in Norway report being with the same primary care professional for more than five years; this is comparable with the OECD PaRIS average of 58%.
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 prioritises 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, Norway demonstrates strong performance compared to the OECD PaRIS average (Figure 6):
Around 60% of people with chronic conditions in Norway receive enough support to manage their own health, slightly below the OECD PaRIS average of 63%.
Norway performs moderately in digital health literacy, with 16% 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 higher proportion (63%) of people with chronic conditions are managed in primary care practices that report being well-prepared to co‑ordinate care, which is above the OECD PaRIS average of 56%.
Nearly all 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 Norway’s strong infrastructure for care co‑ordination and electronic medical record adoption, with room for improvement in digital health literacy and patient support.
Among people with chronic conditions, there are differences in well-being and trust in the healthcare systems across genders in Norway, both indicators being generally lower for women (Figure 7 and Figure 8).
The gender gap in well-being in Norway is similar to the OECD PaRIS average (5 points). This gender gap mirrors results for other countries; however, Norway performs better than the OECD PaRIS average in terms of well-being for both men and women.
While about 76% of men with chronic conditions in Norway have trust in the healthcare system, only 70% of women have trust in the healthcare system. These results for trust are higher than the OECD PaRIS average for men (67%) and women (58%).
The gender gap in trust in Norway (6 percentage points) is smaller than 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 higher incomes report about better well-being than those with lower incomes, with 13 points difference between two groups. Norway levels are higher than the OECD PaRIS average.
In Norway, among people living with chronic conditions, eight out of ten people (81%) with higher income trust healthcare, compared to 67% 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 14 percentage point gap in trust in healthcare system between high- and low-income groups in Norway is higher than the 11 percentage point gap for 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 Norway are based on 8 684 patients and 121 primary care practices. Patients were sampled by probability sampling from the registry of patients of participating practices. Primary care practices were sampled by probability sampling from the primary care registration platform.
In Norway, 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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