The PaRIS (Patient-Reported Indicator Surveys) project, led by the OECD, captures patient-centred outcomes and experiences for people aged 45+ with chronic conditions. It is the first international survey of its kind, providing indicators across 19 countries. As part of this initiative, Belgium conducted its main survey between March 2023 and January 2024. A total of 4,687 patient survey responses were analysed, which resulted in a 33.4% participation rate for Belgium. Surveys were completed online (59.7%) and on paper (40.3%). Findings are focussing on respondents with at least one chronic condition (n = 3,503).
Patient-reported outcome measures (PROMs):
• Nearly three-quarters (72.2%) of the respondents reported having a good general health. However, as the number of chronic conditions increased, perceptions of general health declined – especially among individuals with lower education and income.
• More than seven out of ten (71.9%) respondents reported a positive well-being. It was generally higher in those without chronic conditions and decreased with more conditions, notably among females and those in lower income groups.
• Just over two-thirds (69.7%) of the sample reported good physical health. Physical health declined as chronic conditions increased, with women reporting slightly lower scores. Higher education and income levels were associated with better physical health, regardless of the number of chronic conditions.
• More than four out of five (82.7%) respondents reported good mental health. While higher education and income were linked to better outcomes, mental health diminished with additional chronic conditions, particularly among women.
• Good social functioning was reported by 85.9% of respondents. However, this declined with increasing number of chronic conditions, particularly among women and those with lower education or income. Conversely, higher education and income were associated with better social functioning, especially for those with two or more chronic conditions.
Patient-reported experience measures (PREMs):
• Over 95% of the respondents reported experiencing good quality of medical care, with minimal variation by chronic conditions or socio-demographic factors. This figure was among the highest of all participating countries, and statistically significantly above the OECD average of 87% (based on one comparative interval).
• Almost two-thirds (63.1%) felt confident in managing their own health, though this confidence declined with an increasing number of chronic conditions.
• Seven out of ten (69.5%) agreed or strongly agreed that the healthcare system is trustworthy. While overall trust was high, minor variations existed: men and individuals with higher education and income tended to express greater trust.
• Just over two-thirds (67.7%) reported good experienced coordination of care. A small yet consistent increase in reported care coordination was observed across age groups. Personcentred care was rated highly, with 92.7% expressing confidence in the personalized nature of their care, regardless of chronic condition count – a statistically significantly higher score than the OECD average of 85% (based on one comparative interval).
General health outcomes and experiences
• General health, well-being, and physical health were closely linked with PREMs. Improvements in PREMs, particularly in quality of care and person-centred care, show substantial gains in these health outcomes.
• Patients within our sample with high blood pressure consistently reported better outcomes and experiences, while those with Alzheimer’s/dementia and depression showed the lowest scores across key indicators.
• Digital health literacy remains a concern. Just 8% of patients with chronic conditions felt confident using online health information. Additionally, digital tools provided by GPs were rarely used—only four patients reported a video consult, and only 58.3% found the website easy to use, especially among those with lower education levels.
• Overall health outcomes were similar between patients with and without care plans, though those without care plans reported better general and physical health. Patients with care plans experienced higher person-centred care, reflecting more individualized and holistic care experiences.
• Financial hardship was linked to poorer physical and mental health, lower well-being, and reduced trust in the healthcare system. Despite this, high ratings for quality and person-centred care suggest healthcare services are effectively addressing the needs of financially vulnerable populations.
Primary care insights:
• All participating primary care practices were capable of exchanging electronic medical records, which were consistently available during consultations.
• Self-management support was mainly provided verbally (85.5%), with additional resources offered through pamphlets, online materials, and goal-setting initiatives.
• Less than half (47.5%) of participating practices were well-prepared to coordinate care effectively. Additionally, Belgium lagged in the involvement of non-physician staff in chronic care management, with participation rates (46.3%) for patients with two or more chronic conditions significantly below the OECD average (83%).
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