Does Healthcare Deliver?

As people get older, living with chronic conditions becomes common. The survey reports that 8 in 10 people aged 45+ who saw a primary care professional in the previous six months have at least one chronic condition. Over half have two or more, and more than a quarter have three or more.

This takes a large toll on people’s lives. PaRIS uses the WHO-5 well-being scale to measure people’s well-being (scores 0-100). This scale includes questions that assess mood, vitality and sense of fulfilment. On average, people with two chronic conditions scored five points lower than those with one chronic condition, while those with three or more chronic conditions scored 14 points lower. 

While higher health spending may be associated with better outcomes, such as physical health, it does not guarantee improved patient outcomes or experiences across the board. In fact, it is possible to achieve better health outcomes at lower levels of health spending. Czechia and Slovenia, for example, both score well while having relatively low health spending per capita. On the other hand, the United States and Switzerland report favourable scores on experienced quality and well-being, with Switzerland spending over the average and the United States spending more than double the amount per capita of some other countries with comparable scores.

While women live longer than men, on average they report poorer physical and mental health in the PaRIS results. Women's well-being scores are also typically 3% to 5% lower than men's. The gap is as high as 9% in some countries. Women are also less likely to report experiences of good quality of care and trust in healthcare. Socio-economic status, age, and living with multiple chronic conditions explain part of the difference, but even when these factors are considered, women's well-being is still worse than men’s.

Older and less educated people have difficulty understanding health information and have less confidence than younger and highly-educated people in using digital technology to manage their health. In Iceland, Australia, France, Wales, Canada, Czechia, and Switzerland, the more educated are at least 10 percentage points more likely to be confident in using health information from the internet. Moreover, on average people with high education are 26 percentage points more likely to say that their primary care practice website is easy to use. It is therefore important to make it easier for all people to understand, use and navigate websites and digital health tools.

There has also been progress in the use of electronic health records to support care. However, while electronic health records are used in 95% of the primary care practices participating in PaRIS, only half of all practices can exchange these records electronically with other practices.