Title page
Contents
Acknowledgements 5
Abstract 6
Executive summary 7
Points saillants 10
Abbreviations 13
1. The PaRIS survey: an introduction 18
1.1. Conceptual framework and research questions 20
1.2. Study design and data collection 22
1.3. Eligibility criteria and sampling 22
2. The Field Trial of the PaRIS survey 24
2.1. Sampling and participation 24
2.1.1. Primary care practices 24
2.1.2. Patients 25
2.2. Participation numbers and response rates 25
2.2.1. Primary care practices 25
2.2.2. Patients 27
2.3. Data collection and administration mode 29
2.4. Participant characteristics 30
2.4.1. Characteristics of participating primary care practices 30
2.4.2. Characteristics of participating patients 31
3. Paradata 38
3.1. Practice questionnaire 38
3.1.1. Completion time 38
3.2. Patient questionnaire 39
3.2.1. Administration mode 39
3.2.2. Administration mode according to patients' age 39
3.2.3. Completion time 41
4. Performance of the patient questionnaire 44
4.1. Performance of questions 44
4.1.1. Missing answers 44
4.1.2. Distribution of answers 45
4.2. Scale construction and reliability 46
4.2.1. Methods 46
4.2.2. Patient-reported outcome measures 48
4.2.3. Patient-reported experience measures 50
4.2.4. Health behaviours 53
4.2.5. Health and healthcare capabilities 54
4.3. Construct validity 56
5. Performance of the practice questionnaire 58
5.1. Performance of questions 58
5.1.1. Missing answers 58
5.1.2. Distribution of answers 59
5.2. Scale construction and reliability 60
5.2.1. Reliability 64
5.3. Validity of practice scales 64
6. Qualitative evaluation 66
6.1. Fieldwork process and evaluation 66
6.1.1. Approach to data collection 66
6.1.2. Responding to the questionnaires 66
6.1.3. Facilitating communication between countries 67
6.2. Communications and engagement strategies 67
6.2.1. Survey among primary care professionals 67
6.2.2. Patient survey 68
6.3. Sampling 69
6.3.1. Practice sample 69
6.3.2. Patient sample 70
6.3.3. Sampling materials 71
6.4. Survey guidance: training sessions, manual and supportive materials 73
6.4.1. Training 73
6.4.2. Survey Operations Manual 73
6.4.3. Supportive materials 74
7. Discussion of the main findings 75
7.1. Sampling and recruitment of primary care practices and patients 75
7.2. Survey questionnaire for patients 75
7.3. Survey questionnaire for primary care practices 77
7.4. Supporting the data collection 77
8. Implications for the Main Survey 79
8.1. Questionnaires 79
8.1.1. Patient questionnaire 79
8.1.2. Practice questionnaire 79
8.1.3. Scale performance 80
8.2. Sampling 80
8.2.1. Sampling method 80
8.2.2. Sample size 80
8.3. Engaging stakeholders 81
8.3.1. Primary care providers 81
8.3.2. Patient representatives 81
8.4. Recruitment of participants 81
8.4.1. Primary care practices 81
8.4.2. Patients 82
8.5. Communications and working with NPMs 82
8.5.1. Use of the Teams channel 82
8.5.2. Survey Operations Manual and supportive materials 82
References 84
OECD Health Working Papers 86
Recent related OECD publications 87
Table 2.1. Number of sampled and consented primary care practices, and gross response rates per country 26
Table 2.2. Response of patients per country 28
Table 2.3. Overview of data collection approach 29
Table 2.4. Prevalence of chronic conditions reported by patients per country 37
Table 3.1. Time (in minutes) for completing the online practice questionnaire by providers per country 38
Table 3.2. Distribution of age groups of participating patients within the administration mode(s) offered by countries 40
Table 3.3. Distribution of administration modes used by patients within age groups 40
Table 3.4. Time (in minutes) for completing the online patient questionnaire per country and language 41
Table 4.1. Test of model fit for PROMIS Global - Physical, PROMIS Global - Mental, and WHO-5; results of confirmatory factor analysis 49
Table 4.2. Patient reported outcome measures in the Field Trial and reliability of (multiple item) constructs (overall model) 50
Table 4.3. Test of model fit for P3CEQ; results of confirmatory factor analysis 51
Table 4.4. Factors loadings of P3CEQ questions; exploratory factor analysis (solution constrained to two factors, with ProMax (oblique) rotation) 52
Table 4.5. Patient reported experience of care measures in the Field Trial and reliability of the P3CEQ total scale and subscales 53
Table 4.6. Health behaviour constructs and related questions in the Field Trial 53
Table 4.7. Dimensionality of 10-item Porter-Novelli Scale to assess patients' preferences for health information; results of exploratory factor analysis 54
Table 4.8. Dimensionality of combined questions (MCBS and eHEALS) to assess patients' confidence in self-management; results of exploratory factor analysis 55
Table 4.9. Health and healthcare capabilities measures in the Field Trial and reliability of constructs 56
Table 4.10. Expected strength of the associations between patient-reported indicator domains 57
Table 5.1. Reliability of the practice constructs at practice level and country level 64
Table 6.1. Sampling of primary care practices: identified barriers, problems, and suggestions to address them for the Main Survey 70
Table 6.2. Sampling of patients: identified barriers and problems, and suggestions to solve these for the Main Survey 71
Figure 1.1. Conceptual framework of the PaRIS survey 21
Figure 2.1. Overview of participating primary care practices per country 26
Figure 2.2. Overview of number of participating patients per country 28
Figure 2.3. Location of participating primary care practices, distribution per country 30
Figure 2.4. Type of participating primary care practices, distribution per country 31
Figure 2.5. Gender identity of participating patients, distribution per country 32
Figure 2.6. Age of participating patients, distribution per country 32
Figure 2.7. Education level of participating patients, distribution per country 33
Figure 2.8. Participating patients born in country of survey versus other country, distribution per country 34
Figure 2.9. Number of chronic conditions reported by participating patients, distribution per country 35
Figure 2.10. Number of chronic conditions (excluding high blood pressure) reported by participating patients, distribution per country 35
Figure 3.1. Administration mode for responding to the patient survey, distribution per country 39
Figure 3.2. Median time (in minutes) to complete the online patient questionnaire, distribution according to age groups 42
Figure 3.3. Median time (in minutes) to complete the online questionnaire for patients without chronic conditions and patients with one or more chronic conditions 43
Figure 6.1. Average evaluation scores of training sessions (scale 1-10) 73
Boxes
Box 1.1. Terms used in this report 20
Box 4.1. Questions of the patient questionnaire with 10% or more missing answers 45
Box 4.2. Four models used in factor analysis 47
Box 5.1. Questions of the primary care practice questionnaire with 10% or more answering 'not sure' 59
Box 5.2. Concepts of the conceptual framework and selected sets of questions of the practice questionnaire 61