Improving quality of care through the OECD Patient Reported Indicator Surveys (PaRIS)

3. Use of PaRIS data for health policy and practice

PaRIS results were published about a year before the interviews for this paper took place, which is a short period given the usual length of policy cycles. Nevertheless, most countries have already used the results for health policy and practice, and some have concrete action plans for implementation. The results show that PaRIS has helped countries identify systemic gaps in how care is organised and experienced from the patient perspective, including primary care and digital health. PaRIS has also confirmed known challenges, but this time from patients’ perspectives, giving healthcare performance assessment a new angle. Governments and healthcare providers have been using these insights to plan practical changes, refine contracts and incentives, align ongoing reforms and strategies, and link with administrative data to guide local improvement and policy decisions. This section details how countries have been using the PaRIS data and results for health policy and practice.

Policymakers and stakeholders have been waiting a long time for PaRIS. While the results were published in 2025, the development and implementation of PaRIS took seven years. During these seven years, countries worked together to design the survey in the international context, develop the PaRIS instruments, translate and cognitively test them, and field-test both the survey design and the instruments. All these activities have been necessary to develop a robust study and prepared the terrain to welcome the study results.

While it might still be early to see the policy and practice impact of PaRIS, many countries have already been using insights to identify gaps and advance policies and reforms. In some cases, PaRIS filled a knowledge gap or supported what has been already known in the country. The additional value of PaRIS has been bringing patient perspective into the topic, making it more policy relevant. While the next edition of the impact study might reveal more results, the initial examples are already providing inspiration to advance the use of PaRIS data for health policy and practice in the future.

Most countries used PaRIS to identify systemic gaps in their healthcare systems

OECD Member and partner countries have a long tradition of collecting health data and benchmarking the results for cross-country learning. Over the past decades, such health data, mainly derived from administrative and clinical sources, have helped countries identify gaps in their system, highlight areas where it performs well and learn from others to strengthen their healthcare system performance. Such an approach supports learning health systems.

PaRIS enriches value to this long tradition of learning health systems culture by adding patient-reported data. Beyond collection, using such data to improve health policies and practices help healthcare systems to become more people centred, addressing the needs of their patients. Figure 3 provides an overview of how countries used PaRIS data and results for health policy and practice.

Figure 3. Most countries used PaRIS to identify gaps, support evidence‑based policy and inform care organisation

Note: The figure is based on the interviews with 16 countries participated in PaRIS Cycle 1.

Seven countries used PaRIS findings to identify gaps in their health system

Countries described using PaRIS findings to identify gaps in how care is organised and experienced, particularly concerning key functions of primary care and digital health. Czechia noted that the digital health domain was weaker than expected. Despite progress with e‑prescribing and digital services, the international comparison suggested that it is still behind peers. Greece highlighted that, even with a fragmented system, trust in health professionals appeared high, which challenged prevailing narratives and warranted closer analysis of what drives trust in the country. Iceland found low confidence in self‑management to be unexpectedly prominent, pointing authorities toward additional research and support for patient capability. Italy said the results drew attention to trust differences by age, with lower trust among younger people prompting further discussion. Luxembourg used the results to identify areas for improvement in its digital health record system (i.e. dossier medical partagé), which is informing reform. Slovenia reported that it previously lacked data on core family practice competencies such as person‑centredness and care co‑ordination, and that PaRIS provided the evidence on these subjects.

These insights are already being used to steer practical changes and guide planning. The Welsh Value in Health Centre is using PaRIS to map where self‑reported breathlessness is most common and is planning “breathlessness hubs” to improve timely diagnosis and access to expertise. PaRIS has also filled primary care information gaps by providing data on workforce readiness in addition to PROMs and PREMs. Data are being linked with other administrative datasets to identify priority cohorts, for example people in the last year of life or those with low confidence managing diabetes. Welsh teams are also applying the findings at cluster level to learn from positive outliers, such as deprived areas reporting higher access to care plans and greater trust in the healthcare system and then conducting site visits to understand what is working.

Four countries reported using PaRIS to confirm previously identified healthcare challenges

PaRIS has helped countries confirm known challenges from the patients’ perspective. In Belgium, findings largely corroborated existing diagnoses, with evidence confirming low digital health literacy, which contrasted with high levels of digitalisation. Additionally, PaRIS strengthened evidence for prior investment in care plans for diabetes and chronic kidney disease. In Greece, PaRIS is underlining the known issue of care co‑ordination in the country. The role of the general practitioner is new in Greece and there is a need for clearer roles in primary healthcare and co‑ordination, and Greece reported that PaRIS insights would feed into ongoing reform. In addition, PaRIS stimulated further interest in out-of-pocket payments and policy discussions around them, which has received policy attention following the OECD’s broader comparative work on the topic. In Norway, access to digital services is already a government priority, and PaRIS further showed that digital services are lagging, providing further evidence to support reform. Additionally, ongoing issues with co‑ordination of services were widely acknowledged and informed new policies regarding task-sharing, notably with nurses, which has recently been implemented in the country. In Portugal, results were described as an extra layer of evidence that confirmed high digital health maturity in the country giving policymakers and stakeholders confidence that reforms are having an effect.

Nine countries used PaRIS data as an evidence base for ongoing reform

Across countries, PaRIS is being used to underpin existing strategies and track reforms as they are implemented. Portugal intends to establish systematic, national collection of PREMs beyond PaRIS. Legislation from 2014 requires healthcare providers to collect patient experience and satisfaction, but implementation has been uneven and infrequent. Some providers collect annually, others every five years, and there is no clear guidance on how to do it well. To address this, Portugal is developing a national platform to collect PREMs and standardise methods and frequency, drawing on PaRIS as the evidence base. In Slovenia, PaRIS results supported the decision to include PREMs and PROMs in the national strategy for primary healthcare. Slovenia reported that PaRIS was useful for policymakers as it is providing concrete evidence when developing policies and recommendations.

Italy is using PaRIS to monitor the roll‑out of new community health facilities launched in 2022 as part of a wider EUR 7 billion investment in community health. PaRIS results are being fed back to local health authorities at the community level and used to assess progress on implementation. Authorities also plan to use Cycle 2 of PaRIS to examine the equity of these reforms across the 19 regions and two autonomous provinces, with a focus on whether patient‑reported experiences are improving consistently in the new community health centres and related digital services (See Section 4).

Czechia reported that having strong, positive results from PaRIS during their primary care reform period was critical in sustaining momentum and supporting ongoing efforts. Additionally, the international comparison from PaRIS helped point to best practice targets for care co‑ordination and national project managers expect subsequent cycles of PaRIS to support implementation. Luxembourg is integrating PaRIS data into the national cancer report to shed light on quality of life, mental health and primary care‑led follow‑up, and the Observatoire de la Santé is applying the data to examine socio‑economic inequalities in cardiovascular health. In Saudi Arabia, where a broader health sector transformation is separating provider, payer and regulatory functions, PaRIS results serve as an analytical tool that identifies challenges and barriers. Norway has used PaRIS findings as evidence in a white paper on the future of general practice services, with the project and its results cited throughout. Wales is using PaRIS to establish a baseline for monitoring the national Women’s Health Plan.

Iceland described PaRIS as reinforcing the direction of ongoing reforms and supporting efforts to improve patients’ first contact with primary care. Before PaRIS, the Reykjavik health system had already moved to open more phone services and expand web access, while increasing capacity by adding staff such as nutritionists, physiotherapists and psychologists. Iceland reported that the PaRIS findings provided further evidence to support these ongoing changes. Iceland also pointed to an increase in the activity of healthcare professionals reviewing medicines with patients, which has emerged as a practical signal of more person‑oriented and co‑ordinated care. This activity has gained traction recently and PaRIS was perceived to be influencing these activities.

Countries have used PaRIS results to shape policy discussions on the organisation of care delivery

PaRIS results are being used to inform discussions on how care is funded and organised. In Slovenia, primary care reimbursement was reformed to increase capitation rates, in recognition of the greater complexity of caring for people with multimorbidity, and policymakers indicated that PaRIS findings reinforced the case for this change. In Greece, lower patient satisfaction and access to care reported in rural areas supported work with the Panhellenic Medical Association on offering a more balanced package of incentives to attract and retain doctors in rural areas. Portugal’s financing agency (ACSS) is working to add patient experience metrics to contracts with local health units, as currently contracts primarily focus on production and access. The PaRIS indicators have also advised reform in Saudi Arabia, where the public payer is considering mandatory collection of patient‑reported outcome measures and is exploring the use of validated, cognitively tested instruments from PaRIS. In Wales, an element on co‑ordination of care is planned to be added to contracting with general practitioners, with PaRIS used to establish the baseline and track the effect of the contractual change over time in subsequent cycles. Wales is also working with health boards to reshape community management of musculoskeletal conditions. Teams are linking administrative datasets with PaRIS to understand demand and capacity across primary and secondary care, tailor services to system activation levels and patient access patterns and provide granular feedback to inform service adjustments.

From use of results to quality improvement and assurance

Participating countries in Cycle 1 have been maximising the use of PaRIS data to better understand their policy priorities. Even though it has only been a year since the release of the flagship report, PaRIS identified knowledge gaps, challenged existing assumptions in the country, supported well-known issues, and provided evidence for national strategies and reforms. Additionally, PaRIS has already been shaping policy discussions on the organisation of care delivery in some countries.

Advancing from using PaRIS data to improving and assuring quality of care will also depend on the extent to which these activities are sustainable. Several countries have already been incorporating PaRIS results into the broader systematic quality measurement efforts in the country, which have also become part of public reporting. In addition, some countries have been developing systems to institutionalise the collection of PROMs and PREMs as part of PaRIS and other programmes. The next section outlines the broader efforts by countries to ensure long-term impact of the results and sustain PaRIS data collection and use.