Does Healthcare Deliver? Results from the Patient‑Reported Indicator Surveys (PaRIS): Saudi Arabia
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 of Saudi Arabia. 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 Saudi Arabian 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 nine out of ten people (93%) with chronic conditions in Saudi Arabia report good mental health, social functioning, and general health, making it the highest-performing country among PaRIS participants in these areas. These results are 10 percentage points above the OECD PaRIS average for mental health and social functioning and 27 percentage points for general health.
However, more than two‑thirds (68%) of people with chronic conditions in Saudi Arabia report good physical health, as measured by physical function, pain, and fatigue. A similar percentage report good well-being (65%), which reflects mood, vitality, and fulfilment. These scores are below the OECD PaRIS average of 70% and 71%, respectively.
Fewer than two out of five (37%) people with chronic conditions in Saudi Arabia report good care co‑ordination, which is below the OECD PaRIS average of 59% and 44 percentage points lower than the highest-performing country (81%).
One in seven (14%) people with two or more chronic conditions in Saudi Arabia are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is more than 30 percentage points lower compared to the OECD PaRIS average of 47%.
Two out of five people with two or more chronic conditions (40%) in Saudi Arabia report being with the same primary care professional for more than five years; this is 18 percentage points below the OECD PaRIS average (58%).
One‑third (27%) of people with chronic conditions are managed in practices that can exchange medical records electronically in Saudi Arabia, significantly below the OECD PaRIS average of 57%.
In Saudi Arabia people with chronic conditions have health outcomes and heath experiences generally above or comparable to the OECD PaRIS average. However, fewer people with chronic conditions in Saudi Arabia report experiences of good care co‑ordination compared to other countries in PaRIS (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 Saudi Arabia, people living with chronic conditions are more likely to have good mental health, social functioning and general health compared other countries in PaRIS (Figure 1):
More than two‑thirds (68%) of people with chronic conditions in Saudi Arabia report good physical health, as measured by physical function, pain, and fatigue. This is slightly below the OECD PaRIS average of 70% and 14 percentage points lower than the highest-performing country (82%).
Nearly all people (93%) with chronic conditions in Saudi Arabia 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 the highest percentage of the population among PaRIS participants, and it is above the OECD PaRIS average of 83% for both indicators.
Nearly two‑thirds (65%) of people with chronic conditions in Saudi Arabia report positive well-being, which reflects mood, vitality, and fulfilment. This is below the OECD PaRIS average of 71% and considerably lower than the highest-performing country (80%).
Nearly all people (93%) with chronic conditions in Saudi Arabia report good general health, the highest performing in PaRIS. This is significantly above the OECD PaRIS average of 66%.
In Saudi Arabia, people living with chronic conditions are more likely to have confidence to manage their own health and trust the health system (Figure 1). However, a low percentage of the population reports good care co‑ordination.
Nearly three‑quarters (73%) of people with chronic conditions in Saudi Arabia feel confident managing their own health, which is above the OECD PaRIS average of 59%. However, the level is 19 percentage points below the highest-performing country.
Fewer than two out of five (37%) people with chronic conditions in Saudi Arabia report good care co‑ordination, which is below the OECD PaRIS average of 59% and 44 percentage points lower than the highest-performing country (81%).
More than four out of five (87%) people with chronic conditions in Saudi Arabia report good person-centred care, care focusing on patient’s needs, which is in line with the OECD PaRIS average of 87% but lower than the highest-performing country (97%).
Nearly nine out of ten (89%) people with chronic conditions in Saudi Arabia report experiencing good quality of care, which is slightly above the OECD PaRIS average of 87% and only 8 percentage points below the highest-performing country (97%).
Nearly three‑quarters (74%) of people with chronic conditions in Saudi Arabia trust their healthcare system, which is significantly 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 PaRIS average. Saudi Arabia scores, for example on mental health, are better than the OECD PaRIS average, and above what is considered as a cutoff for good-fair physical health (42). Specifically:
In Saudi Arabia, people with three or more chronic conditions are less likely to report good health compared to those with two chronic conditions. This pattern is consistent with other countries’ results.
People living with multiple chronic conditions in Saudi Arabia have poorer physical health compared to those living with one chronic condition with an eight‑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 Saudi Arabia are slightly higher than the OECD PaRIS average (Figure 2). For example, while the average physical health score of people is above the good-fair cutoff point (42) in Saudi Arabia, the OECD PaRIS average lies below the cutoff for people with three or more chronic conditions.
Similarly, Saudi Arabia performs better than the OECD PaRIS regarding the mental health of people living with one, two, and three or more chronic conditions. People with three or more chronic conditions in Saudi Arabia report poorer mental health than those with one chronic condition with a five‑point difference. However, people with three or more chronic conditions in Saudi Arabia score higher than the OECD PaRIS average for people with one chronic condition (Figure 3).
As in other countries, in Saudi Arabia, people with multiple chronic conditions are less likely to report good social functioning than people with one chronic condition (Figure 4). However, the gap in Saudi Arabia is smaller than in most other countries. While 98% of people with one chronic condition in Saudi Arabia have good social functioning, this goes down only to 90% of people with three or more chronic conditions, which is 15 percentage points 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.
Saudi Arabia performs below average in most primary care features (Figure 5):
More than one out of ten people (14%) with two or more chronic conditions in Saudi Arabia are managed in primary care practices that offer follow-up and regular consultations of more than 15 minutes; this is lower compared to the OECD PaRIS average of 47%.
In Saudi Arabia, almost three out of four people (73%) with two or more chronic conditions are managed in primary care practices where non-physician staff is involved in chronic disease management; this is 10 percentage points below the OECD PaRIS average.
More than three out of five people (63%) with three or more chronic conditions in Saudi Arabia report that their medication was reviewed by a healthcare professional over the past 12 months (Figure 5); this is below the OECD PaRIS average of 75%.
Two out of five people with two or more chronic conditions (40%) in Saudi Arabia report being with the same primary care professional for more than five years; this is below 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 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, Saudi Arabia demonstrates mixed performance compared to the OECD PaRIS average (Figure 6):
Almost half (47%) of the people with chronic conditions in Saudi Arabia receive enough support to manage their own health, below the OECD PaRIS average of 63%.
Saudi Arabia performs comparable to the OECD PaRIS average in digital health literacy, with 18% 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 slightly higher proportion (60%) 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 27% 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 reveal challenges in providing adequate support for patients and exchanging electronic medical record systems in primary care settings.
Among people with chronic conditions, there are differences in well-being and trust in the healthcare systems across genders in Saudi Arabia, both indicators being generally lower for women (Figure 7 and Figure 8).
This gender gap in Saudi Arabia mirrors results for other countries with men reporting higher levels of well-being than women.
While trust in the healthcare system is generally high in Saudi Arabia, men more often trust the healthcare system than women (respectively 77% and 70%). Despite the gap, trust levels are high in both groups compared to the OECD PaRIS average (67% for men and 58% for women).
The gender gap in trust in Saudi Arabia (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 health system (Figure 9 and Figure 10):
Across OECD PaRIS countries, people with higher incomes report better well-being than those with lower incomes (7 points difference). Well-being levels in Saudi Arabia are slightly lower for people with high incomes and slightly higher for people on low incomes, compared to the OECD PaRIS average.
Eight out of ten people with chronic conditions In Saudi Arabia (80%) with higher incomes trust the healthcare system, compared to 73% of people with lower income. The trust levels in all income groups are higher than the OECD PaRIS average (70% for high and 59% for low incomes).
The gap in trust level between income groups in Saudi Arabia is smaller than the OECD PaRIS average (respectively 10% and 19%).
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 Saudi Arabia are based on 7 579 patients and 100 primary care practices. Patients were selected by consecutive sampling with randomisation from patient records from the Directorate of Primary Care, Ministry of Health, and registries of participating practices. Primary care practices were selected by probability sampling from registries of the Ministry of Health, Defence, and publicly available information.
In Saudi Arabia, primary care practices responded to the questionnaire online. Patients responded to the questionnaire via telephone.
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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