Abstract
Background: The Organisation for Economic Co-operation and Development (OECD) Patient-Reported Indicator Surveys (PaRIS) initiative was launched to improve care for people living with chronic conditions through the development, standardization and implementation of meaningful health outcome and experience indicators. This international survey includes patient reported experience metrics that address the organization and coordination of care.
Approach: A pilot test for the PaRIS survey was conducted in Ontario, Canada in the fall of 2022. The pilot study aimed to recruit one primary care provider per primary care practice. To be eligible for this pilot study, participating primary care practices needed to be able to generate an electronic list of eligible individuals for the survey and to send an email to those participants with a link to the PaRIS survey. To simplify recruitment, the eligibility criteria for patients were those aged 45 or older who had visited the primary care practice in the past 6 months.
Results: A total of 867 respondents representing 16 primary care practices completed the survey. The majority of the participants were Caucasian (95%); identified as women (64%); born in Canada (85%); and aged 55-64 (35%). When asked about involvement in care decision making, upwards of 56% of participants in each of the primary care practices reported ‘always’ being as involved as they wanted to be decisions about their care. Responses to overall healthcare organization were more variable, with 11% of respondents from one primary care practice reporting that their healthcare was ‘not at all’ organized in a way that works for them. Finally, when asked about safety problems within primary care, across all practices the majority of participants (67% or more) reported that they rarely or never had a safety problem.
Implications: The PaRIS survey represents an important new international initiative in collecting and reporting on patient reported outcome measures (PROM) and patient reported experience measures (PREMs) in primary care. Administered to primary care practices within the Ontario Health Team integrated care system, these pilot results provide patient perspectives on the overall coordination of care. Patient reported experience with healthcare organization remains an area of concern. The implementation of specific chronic disease care pathways within OHTs may improve patient experience in this area. Future research should explore patient experience with adverse safety events to identify any avoidable or potentially avoidable care management concerns. Next steps will involve international comparisons of health system performance to further this OECD patient focused initiative.