PaRIS Patient Questionnaire

(PaRIS-PQ)
 OECD PaRIS Patient
Questionnaire (PaRIS-PQ)

Version for scripting online survey

2024

© OECD 2024 The use of this work, whether digital or print, is governed by the Terms and
Conditions to be found at https://www.oecd.org/termsandconditions.

PUBE
Table of contents

Background 3
OECD PaRIS-PQ for scripting 4

Annex A. Source questionnaires of the PaRIS-PQ 41

Background

The OECD's Patient-Reported Indicator Surveys (PaRIS) initiative aims to evaluate healthcare
outcomes and patient experiences internationally, with a focus on primary care performance. The
primary tool used in this initiative is the PaRIS Patient Questionnaire (PaRIS-PQ), designed to assess
the experiences and outcomes of patients aged 45 years and older managed in primary care. Alongside
patient-reported outcomes and experience measures (PROMs and PREMs), the PaRIS-PQ includes
items about sociodemographic factors, health behaviours, and healthcare capabilities. To offer further
context and insights into patient-reported experiences and outcomes, a complementary questionnaire
called the PaRIS Primary Care Practice Questionnaire (PaRIS-PCPQ) is employed to evaluate practice
characteristics and the care delivered, particularly focusing on chronic condition management.

The development of the PaRIS-PQ involved close collaboration with policymakers, patients, and
primary care providers. It is grounded in the PaRIS conceptual framework, developed through a rigorous
process involving literature review and a modified Delphi process. The questionnaire underwent
translation into the languages of participating countries, cross-national cognitive testing, and pilot
testing in a field trial.

This document presents the English source version of the PaRIS-PQ for scripting an online survey,
used for data collection between 2022 and 2023. Additionally, it includes the sources for the items
incorporated into the PaRIS-PQ.

The PaRIS Initiative (Patient-Reported Indicator Surveys) of the OECD aims to develop and implement
internationally comparable patient-reported indicators, more specifically patient-reported outcome
measures (PROMs) and patient-reported experience measures (PREMs).
The OECD developed the PaRIS survey instruments with an international consortium of Nivel, Ipsos,
University of Exeter, Optimedis AG and Avedis Donabedian Research Institute.
OECD PaRIS-PQ for scripting

Note to the reader: The PaRIS PQ was administered mainly online, but also on paper and
by telephone depending on the best suited mode for the country. The layout of this
document uses the PaRIS PQ version for scripting the online survey, rather than the paper-
based version. Please note following elements for clarification:
- ASK ALL: item is applicable to all respondents
- ASK IF: applicability of the item is conditional on another item
- (SINGLE): items where respondents can give one of the response options
- (MULTI): items where respondents may tick multiple response options
- (LOOP): items consisting of multiple questions, each with the same answering
categories
- Terms marked with a * are defined in a glossary at the end of this document

This survey is being carried out by <<insert national relevant organization in each
country>> in collaboration with the Organisation for Economic Cooperation and
Development (OECD). <<insert country>> is taking part in an international survey to
improve health services locally and nationally.

The survey asks questions about your experience of care and treatment by your
<<primary care provider>>. Primary care services are usually the first point of contact
with the health service for a wide range of new and long-term health problems. They
are frequently delivered by teams of health care professionals, usually coordinated by
a family doctor or a general practitioner working in a primary care centre. In your case
this may be also another member of the primary care team, such as a nurse, or another
specialist doctor.

In addition, there are some questions about you and your health. Your answers are
important and will help policy makers and health care providers improve health care
based on patients’ needs.

The survey should take around 25 minutes, depending on the answers you give. If you
cannot complete the survey in one session and would like to come back and finish later,
just close the window and your responses will be saved. When you are ready, you can
return to the same point.

Taking part in this survey is voluntary and your answers will be treated in confidence.
If you do not wish to answer a question, please click the >> button twice to move on.

For more information about this survey and how we will use your data, please click on
the link below to view the privacy policy.

If you have any queries about the questionnaire, please call our helpline number on
[LOCAL NUMBER] or email [LOCAL EMAIL].

CONSENT (SINGLE CODE)

Do you agree to take part in the survey?

Yes CONTINUE
No CLOSE
 5

SECTION 1 “Your Health” TIMING START

ASK ALL
NEW PAGE

Your health
The first few questions are about your health.
Questions Source
Q_AGE (SINGLE) Modified from
How old are you? OECD PISA-
D Main Study
1 44 years old or younger Teacher
2 45-49 years old Questionnaire
3 50-54 years old IS
4 55-59 years old
5 60-64 years old
6 65-69 years old
7 70-74 years old
8 75-79 years old
9 80-84 years old
10 85 years or older
97 Prefer not to say

IF Q_AGE = 1 PARTICIPANTS ARE INELIGIBLE AND SHOULD NOT CONTINUE

ASK ALL
NEW PAGE
Questions Source
Q_GLOBAL (LOOP) PROMIS®
GLOBAL01 In general, would you say your health is: Scale v1.2 –
GLOBAL02 In general, would you say your quality of life is: Global Health
GLOBAL03 In general, how would you rate your physical health?
GLOBAL04 In general, how would you rate your mental health,
including your mood and your ability to think?
GLOBAL05 In general, how would you rate your satisfaction with
your social activities and relationships?
GLOBAL9R In general, please rate how well you carry out your
usual social activities and roles. (This includes
activities at home, at work and in your community, and
responsibilities as a parent, child, spouse, employee,
friend, etc.)

Responses (SINGLE)
1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
6

ASK ALL
NEW PAGE
Questions Source
Q_GLOBAL06 (SINGLE) PROMIS®
Scale v1.2
To what extent are you able to carry out your everyday physical
– Global
activities such as walking, climbing stairs, carrying groceries, or Health
moving a chair?
1 Completely
2 Mostly
3 Moderately
4 A little
5 Not at all

ASK ALL
NEW PAGE
The next few questions are about any specific symptoms you may have recently
experienced.

ASK ALL
NEW PAGE
Questions Source
Q_PROMISDYSCB001 (SINGLE) PROMIS Item
In the past 7 days Bank v. 1.0 –
Dyspnea
I have been short of breath
1 Not at all
2 A little bit
3 Somewhat
4 Quite a bit
5 Very much

ASK ALL
NEW PAGE
Questions Source
Q_GLOBAL08R (SINGLE) PROMIS®
In the past 7 days Scale v1.2 –
Global Health
How would you rate your fatigue on average?
1 None
2 Mild
3 Moderate
4 Severe
5 Very severe
 7

ASK ALL
NEW PAGE
Questions Source
Q_PROMISPAIN (SINGLE) PROMIS Adult
In the past 7 days Short Form
v1.0 - Pain
How much did pain interfere with your day-to-day activities? Interference
1 Not at all
2 A little bit
3 Somewhat
4 Quite a bit
5 Very much

ASK ALL
NEW PAGE
Questions Source
Q_GLOBAL07R (SINGLE) PROMIS®
In the past 7 days Scale v1.2 –
Global Health
How would you rate your pain on average?
0-No pain
1
2
3
4
5
6
7
8
9
10-Worst imaginable pain

ASK ALL
NEW PAGE
Questions Source
Q_ GLOBAL10R (SINGLE) PROMIS®
In the past 7 days Scale v1.2 –
Global Health
How often have you been bothered by emotional problems such as
feeling anxious, depressed or irritable?
1 Never
2 Rarely
3 Sometimes
4 Often
5 Always
8

ASK ALL
NEW PAGE
Questions Source
(REPEAT ON EACH SCREEN) For the next few questions, please WHO Well-
think about how you have been feeling over the last two weeks. being Index
(WHO-5)
QWHO5 (LOOP)
A I have felt cheerful and in good spirits
B I have felt calm and relaxed
C I have felt active and vigorous
D My daily life has been filled with things that interest
me
E I woke up feeling fresh and rested

Responses (SINGLE)
1 All of the time
2 Most of the time
3 More than half of the time
4 Less than half of the time
5 Some of the time
6 At no time

SECTION 1 ‘Your health’ TIMING END

 9

SECTION 2 ‘Managing your health and health care’ TIMING START

ASK ALL
NEW PAGE
Managing your health and health care
The next few questions ask about your recent physical activity, diet and use of tobacco
and alcohol and the support you may have received from health care professionals
(doctors, nurses, and other health care professionals). Please respond in relation to your
experience of care and treatment by your <<primary care provider>>. Primary care
services are usually the first point of contact with the health service for a wide range of
new and long-term health problems.

ASK ALL
NEW PAGE (SAME SCREEN)
Questions Source
Q_EXERCISE (SINGLE) Modified from
In the past week, on how many days did you do at least 30 minutes IPAQ-SF
of either vigorous or moderate activity (such as running, swimming,
riding a bike, brisk walking, or dancing)? Vigorous physical activities
typically make you breathe much harder than normal, whereas
moderate activities make you breathe somewhat harder than normal.

1 Every day
2 5 to 6 days
3 3 to 4 days
4 1 to 2 days
5 I did not do any vigorous or moderate activity in the past week
6 Not sure

ASK ALL
NEW PAGE
Questions Source
Q_ADVPHYSACT (SINGLE) Modified from
In the past 12 months, has any health care professional talked with CWF2017IHP
you about your physical activity?
1 Yes
2 No
3 Not sure
10 

ASK ALL
NEW PAGE
Questions Source
Q_EHISFR (SINGLE) Modified from
How often do you eat fruit, excluding juice squeezed from fresh fruit European
or made from concentrate? Health
Interview 2020
1 More than once a day Edition
2 Once a day
3 4 to 6 days a week
4 1 to 3 days a week
5 Less than once a week
6 Never

ASK ALL
NEW PAGE
Questions Source
Q_EHISVG (SINGLE) Modified from
How often do you eat vegetables or salad, excluding potatoes and European
fresh juice or juice made from concentrate? Health
Interview 2020
1 More than once a day Edition
2 Once a day
3 4 to 6 days a week
4 1 to 3 days a week
5 Less than once a week
6 Never

ASK ALL
NEW PAGE
Questions Source
Q_ ADVDIET (SINGLE) Modified from
In the past 12 months, has any health care professional talked with CWF2017IHP
you about healthy eating?

1 Yes
2 No
3 Not sure
  11

ASK ALL
NEW PAGE
Questions Source
Q_EHISSK01 (SINGLE) European
Do you smoke any tobacco products (excluding electronic cigarettes Health
or similar electronic devices)? Interview 2020
Edition
1 Yes, daily
2 Yes, occasionally
3 Not at all

ASK IF Q_EHISSK01 = 3
NEW PAGE
Questions Source
Q_EHISSK04 (SINGLE) Modified from
Have you ever smoked tobacco products (excluding electronic European
cigarettes or similar electronic devices) daily, or almost daily, for at Health
least one year? Interview 2020
Edition
1 Yes
2 No

ASK IF Q_EHISSK01 = 1 or 2 OR Q_EHISSK04=1

NEW PAGE
Questions Source
Q_CWF2017IHP (SINGLE) Modified from
In the past 12 months, has any health care professional talked with CWF2017IHP
you about the health risks of smoking or using tobacco and ways to
quit?
1 Yes
2 No
3 Not sure
12 

ASK ALL
NEW PAGE
Questions Source
Q_EHIS (SINGLE) European
In the past 12 months, how often have you had an alcoholic drink of Health
any kind (beer, wine, cider, spirits, cocktails, premixes, liquor, Interview 2020
homemade alcohol …)? Edition

1 Every day or almost

2 5-6 days a week
3 3-4 days a week
4 1-2 days a week
5 2-3 days in a month
6 Once a month
7 Less than once a month
8 Not in the past 12 months, as I no longer drink alcohol
9 Never, or only a few sips or tries, in my whole life

ASK IF Q_EHIS = 1 TO 8
NEW PAGE
Questions Source
Q_CWF2017IHP (SINGLE) Modified from
In the past 12 months, has any health care professional talked with CWF2017IHP
you about alcohol use?
1 Yes
2 No
3 Not sure

SECTION 2 ‘Managing your health and health care’ TIMING END

  13

SECTION 3 ‘PN and CONFIDENT’ TIMING START

ASK ALL
NEW PAGE
Q_PN (show each question on separate screens)
(Put this text on separate screen). The next few questions are about how you and the
health care professionals that you usually see support your health and health care. Please
respond in relation to your experience of care and treatment by your <<primary care
provider>>.

Questions Source
PN1 I rely on health care professionals to tell me Modified from Porter-
everything I need to know to manage my health Novelli Consumer
Preferences Scale
PN2 Most health issues are too complex for me to Porter-Novelli
understand Consumer Preferences
Scale
PN3 I actively try to prevent diseases and illnesses Porter-Novelli
Consumer Preferences
Scale
PN4 I leave it to health care professionals to make the Modified from Porter-
right decisions about my health Novelli Consumer
Preferences Scale
PN5 It is important to me to be informed about health Porter-Novelli
issues Consumer Preferences
Scale
PN6 I need to know about health issues so I can keep Porter-Novelli
myself and my family healthy Consumer Preferences
Scale
PN7 I have difficulty understanding a lot of the health Porter-Novelli
information that I read Consumer Preferences
Scale
PN8 My health care professionals and I work together Modified from Porter-
to manage my health Novelli Consumer
Preferences Scale
PN9 When I read or hear something that is relevant to Modified from Porter-
my health care, I bring it up with my health care Novelli Consumer
professionals Preferences Scale
PN10 I try to understand my personal health risks Porter-Novelli
Consumer Preferences
Scale
PREOS2m When I think something is wrong with my health Modified from PREOS-
care, I raise my concerns with my health care PC-6
professionals
Responses (SINGLE)
1 Strongly disagree
2 Disagree
3 Neither agree nor disagree
4 Agree
5 Strongly agree
14 

ASK ALL
NEW PAGE
Q_CONFIDENT (LOOP)

Questions Source
P3CEQ10 How confident are you that you can manage Modified from
your own health and wellbeing? Person-Centred
Coordinated
Care Experience
Questionnaire
(P3CEQ)
MPBSPAINSTRC How confident are you that you can follow Modified from
instructions from health care professionals Medicare
about how you should care for yourself at Patient
home? Engagement
Questions
MPBSPAMEDREC How confident are you that you can follow Modified from
instructions from health care professionals Medicare
about how to change your habits or lifestyle? Patient
Engagement
Questions
MPBSPANECESS How confident are you that you can identify Modified from
when it is necessary for you to get medical Medicare
care? Patient
Engagement
Questions
MPBSPASIDEFX How confident are you that you can identify Modified from
when you are having side effects from your Medicare
medications? Patient
Engagement
Questions
eHEALS How confident are you in using information Modified from
from the Internet to make health decisions? eHealth Literacy
Scale (eHEALS)

Responses (SINGLE)
1 Very confident
2 Confident
3 Somewhat confident
4 Not confident at all
5 Does not apply (MPBSPASIDEFX and
eHEALS only)

SECTION 3 ‘PN and CONFIDENT’ TIMING END

  15

SECTION 4 ‘Your experience of health care – part 1’ TIMING START

ASK ALL
NEW PAGE
Your experience of health care
Please respond in relation to your experience of care and treatment by your <<primary
care provider>>.
ASK ALL
NEW PAGE
Q_CWF1130 (SINGLE)

Questions Source
Is there one single professional you usually go to for most of your Modified from
health problems? CWF2016IHP
1 Yes, a doctor
2 Yes, another health care professional
3 No, there is no single health care professional I usually go for most
of my health problems
4 Not sure

ASK IF Q_CWF1130 = 1
NEW PAGE
Q_ USUALDR1 (SINGLE)
Questions Source
Who is this doctor? OECD PaRIS

1 A doctor specialised in family

medicine/general practice
2 Another specialist doctor
3 Not sure

ASK IF Q_CWF1130 = 1
NEW PAGE
Q_CWF1140 (SINGLE)
Questions Source
How long have you been seeing this doctor? Modified from
CWF2016IHP
1 1 year or less
2 More than 1 year but no more than 3 years
3 More than 3 years but no more than 5 years
4 More than 5 years but no more than 10 years
5 More than 10 years
6 Not sure
16 

ASK IF Q_CWF1130 = 1
NEW PAGE
Q_ USUALDR2 (SINGLE)
Questions Source
How many times have you seen this doctor in the past 12 months? OECD PaRIS
This could be in person, on the phone, by video call or online
messaging.
1 Not in the past 12 months
2 1 time
3 2 times
4 3 times
5 4 times
6 5 times or more
7 Not sure

ASK IF Q_CWF1130 = 2
NEW PAGE
Q_ USUALDR3 (SINGLE)
Questions Source
Who is this health care professional? OECD PaRIS

1 A doctor specialised in family

medicine/general practice
2 Another specialist doctor
3 A nurse
7 Nurse practitioner
4 An allied health care professional, such as
a physiotherapist, dietician, or podiatrist
5 Another health care professional
6 Not sure

ASK IF USUALDR3 = 1-3

NEW PAGE
Q_ USUALDR4 (SINGLE)
Questions Source
How long have you been seeing this health care professional? OECD PaRIS
1 1 year or less
2 More than 1 year but no more than 3 years
3 More than 3 years but no more than 5 years
4 More than 5 years but no more than 10 years
5 More than 10 years
6 Not sure
  17

ASK IF USUALDR3 = 1-3

NEW PAGE
Q_ USUALDR5 (SINGLE)
Questions Source
How many times have you seen this health care professional in the OECD PaRIS
past 12 months? This could be in person, on the phone, by video call
or online messaging.

1 Not in the past 12 months

2 1 time
3 2 times
4 3 times
5 4 times
6 5 times or more
7 Not sure

SECTION 4 ‘Your experience of health care – part 1’ TIMING END

18 

SECTION 5 ‘Your experience of health care – part 2’ TIMING START

ASK ALL
NEW PAGE
Q_CHRONCOND (MULTI, OPEN)
Questions Source
Have you ever been told by a doctor that you have any of the OECD PaRIS
following health conditions?
Please select all the options that apply.
1 High blood pressure
2 Cardiovascular or heart condition
3 Diabetes (type 1 or 2)
4 Arthritis or ongoing problem with back or joints
5 Breathing condition (e.g., asthma or COPD)
6 Alzheimer’s disease or other cause of dementia
7 Depression, anxiety or other mental health condition (e.g.,
bipolar disorder or schizophrenia) (ongoing)
8 Neurological condition (e.g., epilepsy or migraine)
9 Chronic kidney disease
10 Chronic liver disease
11 Cancer (diagnosis or treatment in the last 5 years)
12 Other long-term problem(s)
13 I have never been told by a doctor that I have any of these
problems

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
The next few questions are about the care you may have received for these health
conditions.

Please respond in relation to your experience of care and treatment by your << primary
care provider>>.
Q_P3CEQ6 (SINGLE)
Questions Source
Do you have a single professional who takes responsibility for Modified from
coordinating your care across the services that you use? Person-
Centred
1 Yes Coordinated
2 No Care
3 I do not receive care from more than one service Experience
4 Not sure Questionnaire
(P3CEQ)
  19

ASK IF Q_CHRONCOND = 1 TO 12 AND Q_P3CEQ6 = 1

NEW PAGE
Q_ P3CEQ5m1 (SINGLE)
Questions Source
Is this the same professional that you see for most of your health OECD PaRIS
problems?
1 Yes
2 No
3 Not sure

ASK IF Q_CHRONCOND = 1 TO 12 AND Q_P3CEQ5m1 = 2 OR 3

NEW PAGE
Q_P3CEQ5m2 (SINGLE)
Questions Source
Who is this professional? OECD PaRIS

1 A doctor specialised in family

medicine/general practice
2 Another specialist doctor
3 A nurse
7 Nurse practitioner
4 An allied health care professional, such as
a physiotherapist, dietician, or podiatrist
5 Another health care professional
6 Not sure

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
Q_P3CEQ5 (SINGLE)
Questions Source
Is your health care organised in a way that works for you? Modified from
Person-
Centred
1 Yes, definitely Coordinated
Care
2 Yes, to some extent
Experience
3 No, not really Questionnaire
4 No, definitely not (P3CEQ)
5 Not sure
20 

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
Q_ROUTINEF (SINGLE)
Questions Source
Are you offered regular follow-up for your health condition(s)? If you OECD PaRIS
have more than one condition, please answer about the condition
that you are seen for most regularly.
1 Yes, about every 3 months or more often
2 Yes, about every 6 months
3 Yes, about every 12 months
4 Yes, over longer periods of time
5 No
6 Not sure

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
Q_P3CE (LOOP)
Questions Source
Modified from
P3CEQ1 Do you discuss with the health care professionals Person-Centred
involved in your care what is most important for you in Coordinated
managing your own health and wellbeing? Care Experience
P3CEQ2 Are you involved as much as you want to be in Questionnaire
decisions about your care? (P3CEQ)
P3CEQ3 Are you considered as a ‘whole person’ rather than
just a disease/condition in relation to your care?

Responses (SINGLE)
1 Yes, definitely
2 Yes, to some extent
3 No, not really
4 No, definitely not
5 Not sure

SECTION 5 ‘Your experience of health care – part 2’ TIMING END

  21

SECTION 6 ‘Your experience of health care – part 3’ TIMING START

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE

Sometimes health professionals support patients in defining health goals. These are
things that are important to you and you want help in achieving.

Q_PCMH4 (SINGLE)
Questions Source
How often does a health care professional talk to you about specific Modified from
goals for your health? Patient-
1 Always Centered
2 Often Medical Home
3 Sometimes (PCMH)
4 Rarely
5 Never
6 Not sure

ASK IF Q_CHRONCOND = 1 TO 12 NEW PAGE

The next few questions are about care plans. A care plan (or plan of care) is a written
agreement between you and your health care professionals detailing the type of care you
receive over an extended period of time and how this care will be given, also including
what you will do yourself. Not everybody has a care plan.
Please respond in relation to your experience of care and treatment by your <<primary
care provider>>.

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
Q_P3CEQ7a
Questions Source
Do you have a care plan that takes into account all your health and Person-
wellbeing needs? Centred
Coordinated
1 Yes Care
2 No Experience
3 Not sure Questionnaire
(P3CEQ)

ASK IF Q_CHRONCOND = 1 TO 12 AND Q_P3CEQ7a = 1

NEW PAGE
Q_P3CEQ7b (SINGLE)
Questions Source
Is this care plan available to you? Modified from
Person-
1 Yes Centred
2 No Coordinated
3 Not sure Care
Experience
Questionnaire
(P3CEQ)
22 

ASK IF Q_CHRONCOND = 1 TO 12 AND Q_P3CEQ7a = 1

NEW PAGE
P3CEQ7c (SINGLE)
Questions Source
To what extent have you found your care plan useful for you to Modified from
manage your health and wellbeing? Person-
Centred
1 Not at all Coordinated
Care
2 To some extent
Experience
3 To a large extent Questionnaire
4 Completely (P3CEQ)
5 Not sure

ASK IF Q_CHRONCOND = 1 TO 12 AND Q_P3CEQ7a = 1

NEW PAGE
P3CEQ7d (SINGLE)
Questions Source
To what extent do all the professionals involved in your care appear Modified from
to be following the same care plan? Person-
Centred
1 Not at all Coordinated
2 To some extent Care
Experience
3 To a large extent Questionnaire
4 Completely (P3CEQ)
5 Not sure

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
Q_P3CEQ8 (SINGLE)
Questions Source
Do you have enough support from your health care professionals to Modified from
help you to manage your own health and wellbeing? Person-
Centred
1 I do not need support Coordinated
2 I have had no support Care
3 I sometimes have enough support Experience
4 I often have enough support Questionnaire
5 I always have enough support (P3CEQ)
6 Not relevant
7 Not sure
  23

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
P3CEQ9 (SINGLE)
Questions Source
To what extent do you receive useful information at the time you need Modified from
it to help you manage your health and wellbeing? Person-
Centred
1 I do not receive any information Coordinated
2 I sometimes receive enough information Care
3 I often receive enough information Experience
4 I always receive enough information Questionnaire
5 I receive too much information (P3CEQ)
6 Not relevant
7 Not sure

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
Q_P3CEQ11b (SINGLE)
Questions Source
Do your health care professionals involve your family, friends and/or Modified from
carers as much as you want them to be in decisions about your care? Person-
Centred
1 No, definitely not Coordinated
2 No, not really Care
3 Yes, to some extent Experience
4 Yes, definitely Questionnaire
5 I do not want my family, friends or carers to be (P3CEQ)
involved
6 My family, friends or carers do not want to be
involved
7 Not applicable

ASK IF Q_CHRONCOND = 1 TO 12
NEW PAGE
Q_MEDCWF1605 (SINGLE)
Questions Source
How many different medications as prescribed by a doctor or a nurse Modified from
are you taking on a regular or ongoing basis? CWF2016IHP

1 No medication
2 1-2 medications
3 3-4 medications
4 5-9 medications
5 10 or more medications
24 

ASK IF Q_CHRONCOND = 1 TO 12 AND Q_MEDCWF1605 = 2 TO 5

NEW PAGE
Q_MEDCWF71110 (SINGLE)
Questions Source
In the past 12 months, has a health care professional reviewed with Modified from
you all medications you take? CWF2017IHP

1 Yes
2 No
3 Not sure

SECTION 6 ‘Your experience of health care – part 3’ TIMING END

  25

SECTION 7 ‘Your experience of health care – part 4’ TIMING START

ASK ALL
NEW PAGE
The next few questions are about your experience with your <<primary care provider>> in
the last 12 months.

Q_ P3CEQ4 (SINGLE)
Questions Source
Were there times when you had to repeat information that should Modified from
have been in your care records? Person-
Centred
1 Yes, definitely Coordinated
2 Yes, to some extent Care
3 No, not really Experience
4 No, definitely not Questionnaire
5 Not sure (P3CEQ)

ASK ALL
NEW PAGE
Q_PREOS3 (SINGLE)
Sometimes patients experience an event or circumstance that could have resulted, or did
result, in unnecessary harm to themselves, such as not getting an appointment when
needed; receiving a wrong or delayed diagnosis or treatment; or experiencing problems
with communications between health care professionals.

Questions Source
How often do you believe you have had any such event or Modified from
circumstance with your primary care centre? PREOS-PC-6

1 Always
2 Often
3 Sometimes
4 Rarely
5 Never
98 Not applicable

ASK ALL
NEW PAGE
Q_PREOS1 (SINGLE)
Questions Source
How often did you feel that the health care professionals at your Modified from
primary care centre encouraged you to talk about any concerns PREOS-PC-6
about your health care?

1 Always
2 Often
3 Sometimes
4 Rarely
5 Never
98 Not applicable
26 

ASK ALL
NEW PAGE
Q_OECDACC3 (SINGLE)
Questions Source
How often did you have a health problem but did not seek care Modified from
because of difficulties in travelling to your primary care centre? OECD
proposed Set
1 Always of Questions
2 Often on Patient
3 Sometimes Experiences
4 Rarely with
5 Never Ambulatory
98 Not applicable Care

ASK ALL
NEW PAGE
Q_ OECDACC46 (SINGLE)
Questions Source
How often did you have a health problem but did not seek care, or did Modified from
not take a prescription medicine because of the cost? OECD
proposed Set
1 Always of Questions
2 Often on Patient
3 Sometimes Experiences
4 Rarely with
5 Never Ambulatory
98 Not applicable Care

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The next questions are about the online services that your primary care centre may offer
to patients like you, such as a website, smartphone app or video consultation

ASK ALL
NEW PAGE
Q_GPPS4 (SINGLE)
Questions Source
How easy is it for you to use your primary care centre’s website to GP Patient
look for information or access services? Survey
(GPPS)
1 Very easy
2 Fairly easy
3 Not very easy
4 Not at all easy
5 I haven’t tried
6 My primary care centre does not have a website
7 Not sure
  27

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Q_GPPS5 (MULTI)
Questions Source
As far as you know, which of the following online services does your Modified from
primary care centre offer? GP Patient
Please select all the options that apply. Survey
(GPPS)
1 Booking appointments online
2 Ordering repeat prescriptions online
3 Accessing my medical records online
4 Video consultations
5 None of these
99 Don’t know

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NEW PAGE
Q_GPPS6 (MULTIPLE)
Questions Source
Which of the following online services offered by your primary care Modified from
centre have you used? GP Patient
Please select all the options that apply. Survey
(GPPS)
1 Booking appointments online
2 Ordering repeat prescriptions online
3 Accessing my medical records online
4 Video consultations
5 None of these

ASK ALL
NEW PAGE
Q_CWF119 (SINGLE)
Questions Source
Overall, how do you rate the medical care that you have received in Modified from
the past 12 months from your primary care centre? CWF2016IHP

1 Excellent
2 Very good
3 Good
4 Fair
5 Poor
6 Have not received medical care in the last 12 months
7 Not sure

SECTION 7 ‘Your experience of health care – part 4’ TIMING END

28 

SECTION 8 ‘Other health services’ TIMING START

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Other health services

The next few questions are about other health services you have used in the last 12
months.

ASK ALL
NEW PAGE
Q_ EMERG (SINGLE)
Questions Source
In the last 12 months, have you been to a hospital emergency Modified from
department for your own medical care? CWF2017IHP
1 No
2 Yes, once
3 Yes, twice
4 Yes, 3 or more times
5 Not sure

ASK ALL
NEW PAGE
Q_CWF2016HOSP (SINGLE)
Questions Source
In the last 12 months, have you been in a hospital for one night or Modified from
longer? CWF2016IHP
1 No
2 Yes, once
3 Yes, twice
4 Yes, 3 or more times
5 Not sure

SECTION 8 ‘Other health services’ TIMING END

  29

SECTION 9 ‘Your last consultation’ TIMING START

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NEW PAGE
Your last consultation (SHOW ON SCREEN FOR ALL QS UP TO Q_OECDEXP5)
The next questions are about the last time that you had a consultation with your <<primary
care provider>> with a doctor, nurse or other health care professional to get care for
yourself. This may have been with your main health care professional, or another health
care professional, and includes consultations over the phone or in a doctor’s office or
clinic.

ASK ALL
NEW PAGE
LAST APP (country specific question to establish eligibility)

ASK ALL
NEW PAGE
Q_PURPOS (SINGLE)
Questions Source
What was the main purpose of this consultation? OECD PaRIS

1 First contact for a new problem

2 Follow-up of a new problem
3 Routine care for a long-term problem
4 Non-routine care for a long-term problem
5 General preventive care
6 Not sure

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Q_OECDACC7a (SINGLE)
Questions Source
Who did you have this last consultation with? If you saw more than Modified from
one health care professional, please select the one you spent most OECD
time with on the day. Please select only one option. proposed Set
of Questions
1 A doctor specialised in family on Patient
medicine/general practice Experiences
2 Another specialist doctor with
3 A nurse Ambulatory
7 Nurse practitioner Care
4 An allied health care professional, such as
a physiotherapist, dietician, or podiatrist
5 Another health care professional
6 Not sure
30 

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Q_OECDACC7b (SINGLE)
Questions Source
Where was this health care professional working? Modified from
1 A primary care centre OECD
2 An outpatient department of a hospital proposed Set
3 Other of Questions
4 Not sure on Patient
5 Not applicable Experiences
with
Ambulatory
Care

ASK ALL
NEW PAGE
Q_OECDACC7c (MULTI)
Questions Source
Which of the following best describes the type of care you received? Modified from
Please select all the options that apply. OECD
1 Face-to-face consultation in the health care proposed Set
professional’s office of Questions
2 Telephone consultation on Patient
3 Video consultation Experiences
4 Home visit with
5 Other Ambulatory
6 Not sure Care

ASK ALL
NEW PAGE
GPPSACCESS (SINGLE)
Questions Source
How long after initially trying to book the appointment did the Modified from
appointment take place? GP Patient
1 On the same day Survey
2 On the next day (GPPS)
3 A few days and up to a week later
4 More than a week and up to one month
later
5 More than one month later
6 Can’t remember
  31

ASK ALL
NEW PAGE
Q_OECDACC9 (SINGLE)
Questions Source
Was the time you waited a problem for you? Modified from
OECD
1 Yes proposed Set
2 No of Questions
3 Not sure on Patient
Experiences
with
Ambulatory
Care

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NEW PAGE
Q_OECDACC8 (SINGLE)
Questions Source
Did this health care professional spend enough time with you? OECD
proposed Set
1 Yes, definitely of Questions
2 Yes, to some extent on Patient
Experiences
3 No, not really with
4 No, definitely not Ambulatory
5 Not sure Care

ASK ALL
NEW PAGE
Q_OECDEXP2 (SINGLE)
Questions Source
Did this health care professional explain things in a way that was OECD
easy to understand? proposed Set
of Questions
1 Yes, definitely on Patient
2 Yes, to some extent Experiences
with
3 No, not really Ambulatory
4 No, definitely not Care
5 Not sure
32 

ASK ALL
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Q_GPPSTRUST (SINGLE)
Questions Source
Did you have confidence and trust in the health care professional you Modified from
saw or spoke to? GP Patient
Survey
1 Yes, definitely (GPPS)
2 Yes, to some extent
3 No, not really
4 No, definitely not
5 Not sure

ASK ALL
NEW PAGE
Q_OECDEXP5 (SINGLE)
Questions Source
Overall, how would you rate the quality of this consultation? OECD
proposed Set
1 Excellent of Questions
on Patient
2 Very good
Experiences
3 Good with
4 Fair Ambulatory
5 Poor Care
6 Not sure

SECTION 9 ‘Your last consultation’ TIMING END

  33

SECTION 10 ‘COVID-19’ TIMING START

ASK ALL
NEW PAGE
The next questions are about if you have tested positive for COVID-19 and symptoms you
may have experienced.

Q_COVID1 (SINGLE)
Questions Source
Have you ever tested positive for COVID-19 (using a rapid point-of- Modified from
care test, self-test, or laboratory test) or been told by a doctor or Household
other health care provider that you have or had COVID-19? Pulse Survey
US
1 Yes
2 No
3 Not sure

ASK IF Q_COVID1 = 1
Q_COVID2 (SINGLE)
Questions Source
Did you have any symptoms lasting 2 months or longer that you did Modified from
not have prior to having coronavirus or COVID-19? Household
Long term symptoms may include: tiredness or fatigue, difficulty thinking, Pulse Survey
concentrating, forgetfulness, or memory problems (sometimes referred to US
as "brain fog", difficulty breathing or shortness of breath, joint or muscle
pain, fast-beating or pounding heart (also known as heart palpitations),
chest pain, dizziness on standing, menstrual changes, changes to
taste/smell, or inability to exercise.

1 Yes, symptoms lasted between 2-3 months

2 Yes, symptoms lasted between 3-6 months
3 Yes, symptoms lasted between 6 months - 1 year
4 Yes, symptoms lasted at least 1 year
5 No
6 Not sure

ASK IF Q_COVID2 = 1 TO 4
Q_COVID3 (SINGLE)
Questions Source
Do you still have these long-term symptoms? Modified from
Household
1 Yes Pulse Survey
2 No US
3 Not sure
34 

ASK IF Q_COVID3 = 1
Q_COVID4 (SINGLE)
Questions Source
Do these long-term symptoms reduce your ability to carry out day- Modified from
to-day activities compared with the time before you had COVID-19? Household
Pulse Survey
1 Yes, a lot US
2 Yes, a little
3 Not at all
3 Not sure

SECTION 10 ‘COVID-19’ TIMING END

  35

SECTION 11 ‘About yourself’ TIMING START

ASK ALL
NEW PAGE
About yourself
Finally, we would like to ask you some information about yourself. It is important to collect
this information to understand whether there are any differences in the quality of services
experienced by different groups of people.

ASK ALL
NEW PAGE
Q_WB151
Questions Source
How much do you weigh? Modified from
WELL-BEING
1 ___kilos (MIN 20, MAX 500) (ALTERNATIVE IN QUESTIONNAIRE
IMPERIAL) FOR PISA 2018
99 Don’t know (INTERNATIONAL
97 Prefer not to say OPTION)

ASK ALL
NEW PAGE
Q_WB152 (SINGLE)
Questions Source
How tall are you? Modified from
WELL-BEING
1 ___centimeters (MIN 50, MAX 250) QUESTIONNAIRE
(ALTERNATIVE IN IMPERIAL) FOR PISA
99 Don’t know 2018(INTERNATIO
97 Prefer not to say NAL OPTION)

ASK ALL
NEW PAGE
Q_ISCED (SINGLE)
Questions Source
What is the highest educational level that you have attained? Modified from
International
1 Early childhood education Standard
2 Primary education Classification
3 Lower secondary education of Education
4 Upper secondary education (ISCED)
5 Post-secondary non-tertiary
education
6 Short-cycle tertiary education
7 Bachelor’s degree or equivalent
level
8 Master’s degree or equivalent level
9 Doctoral or equivalent level
36 

ASK ALL
NEW PAGE
Q_SEX (SINGLE, OPEN)
Questions Source
Which of the following best describes you? Modified from
OECD Risks
1 Female That Matter
2 Male
3 LEAVE BLANK
4 Other
97 Prefer not to say

ASK ALL
NEW PAGE
Q_GENDERID (COUNTRY SPECIFIC QUESTION)

ASK ALL
NEW PAGE
Q_LGBT (SINGLE)
Questions Source
This question is about your sexual orientation. Do you identify as: Modified from
UK National
1 Heterosexual or straight (that is, attracted to the opposite LGBT Survey
sex)
2 Homosexual (gay or lesbian, that is, attracted to the same
sex)
3 Bisexual (attracted to both sexes)
4 Other
97 Prefer not to say

ASK ALL
NEW PAGE
Q_OECDLIT5a (SINGLE)
Questions Source
Which of these terms best describes your current work situation? OECD
Measuring
1 Self-employed [work for yourself] Financial
2 In paid employment [work for someone else] Literacy
3 Looking for work
4 Looking after the home
5 Unable to work due to sickness or ill-health
6 Retired
7 Student
8 Not working and not looking for work
9 Apprentice
10 Other
99 Don’t know
  37

ASK ALL
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Q_OECDLIT7 (SINGLE)
Questions Source
Which of these categories does your household net income usually Modified from
fall into? OECD
Measuring
1 Up to $X a month Financial
2 Between $X and $Y a month Literacy
3 $Y or more a month
99 Don’t know
97 Prefer not to say

ASK ALL
NEW PAGE
Q_MONMED (SINGLE)
Questions Source
In the past 12 months, did you have problems paying or were National Health
unable to pay any medical bills? Interview Survey
(NHIS)
1 Yes
2 No
98 Not applicable

ASK ALL
NEW PAGE
Q_MON (Show on different screens)
Questions Source
How often in the past 12 months would you say you were worried Modified from
or stressed about the following things? 2017
Commonwealth
MONMEAL Having enough money to buy healthy meals? Fund
MONRENT Having enough money to pay your rent or mortgage? International
MONBILLS Having enough money to pay for other monthly bills, Health Policy
like electricity, heat, and your telephone? Survey of Older
Adults
Responses (SINGLE)
1 Always
2 Often
3 Sometimes
4 Rarely
5 Never
38 

ASK ALL
NEW PAGE
MEDHIMS6
Questions Source
Were you born in (SURVEY COUNTRY)? (SINGLE, OPEN) Mediterranean
Household
1 Yes International
2 No (Please state the country you were born in Migration
_____________) Survey (MED-
HIMS)

ASK ALL
NEW PAGE
MEDHIMS7
Questions Source
Are you a citizen of (SURVEY COUNTRY)? (SINGLE, OPEN) Mediterranean
Household
1 Yes International
2 No (Please state what country you are a citizen of Migration
_____________) Survey (MED-
HIMS)

ASK ALL
NEW PAGE
Q_OECDLITii
Questions Source
Which of these best describes the type of area in which you live? Modified from
1 City OECD
2 Town or suburb Measuring
3 Rural area Financial
4 Don’t know Literacy

ASK ALL
NEW PAGE
OECDLIT2a (OPEN)
Questions Source
How many children under the age of 18 live with you, in your OECD
household? Measuring
WRITE IN NUMBER (MIN 0, MAX 20) Financial
Literacy

ASK ALL
NEW PAGE
OECDLIT2b (OPEN)
Questions Source
How many people aged 18 and over live with you, in your household? OECD
Please do not count yourself Measuring
WRITE IN NUMBER (MIN 0, MAX 20) Financial
Literacy
  39

ASK ALL
NEW PAGE
WHODIS (Show on different screens)
Questions Source
Should you need help, how easy is it for you to get help from the Modified from
following people? WHO/ World
Bank model-
WHODIS1 A close family member (including your partner)? disability-survey
WHODIS2 Friends, neighbours and co-workers?

Responses (SINGLE)
1 Very easy
2 Easy
3 Neither easy nor difficult
4 Difficult
5 Very difficult
6 Not applicable

ASK ALL
NEW PAGE
WHOWB11 (SINGLE)
Questions Source
Do you need physical care or support, such as help with eating, Modified from
dressing, bathing, moving around the house or assistance outside WHO/ World
the house such as for using transportation? Bank model-
disability-survey
1 Yes
2 No

ASK ALL
NEW PAGE
Q_WHOWB12 (SINGLE)
Questions Source
Do you need emotional care or support, such as comfort, advice Modified from
or counseling? WHO/ World
Bank model-
1 Yes disability-survey
2 No

ASK ALL
NEW PAGE
Q_WHOWB13 (SINGLE)
Questions Source
Do you need support for health care, such as administering Modified from
medicines, changing bandages or arranging for appointments WHO/ World
with primary care providers? Bank model-
disability-survey
1 Yes
2 No
40 

ASK ALL
NEW PAGE
Q_TRUST
Questions Source
How strongly do you agree or disagree that the health care system OECD PaRIS
can be trusted?
1 Strongly disagree
2 Disagree
3 Neither agree nor disagree
4 Agree
5 Strongly agree

ASK ALL
NEW PAGE
Q_RESPONDENT
Questions Source
Who was the main person or people that filled in this questionnaire? NHS Inpatient
Survey 2022
1 The person invited to complete the survey
2 A friend or relative of the person invited to complete the survey
3 Both the person invited to complete the survey and a friend or
relative together
4 The person invited to complete the survey with the help of a health
care professional or care worker

Thank you for taking the time to

complete this questionnaire
SECTION 11 ‘About yourself’ TIMING END
  41

Annex A. Source questionnaires of the PaRIS-PQ

Source Reference
Commonwealth Fund The Commonwealth Fund (2016), International Health Policy Survey.
(CWF) Surveys: 2016 IHP,
2017 IHP The Commonwealth Fund (2017), International Health Policy Survey.

eHealth Literacy Scale Norman CD, Skinner HA (2006a), eHEALS: The eHealth literacy
(eHEALS) scale. Journal of Medical Internet Research, 8(4).
European Health Interview Eurostat and European Commission (2020), European Health Interview
2020 Edition Survey (EHIS wave 3) Methodological
manual. Luxembourg: Publications Office of the European Union.
GP Patient Survey (GPPS) Campbell J, Smith P, Nissen S, Bower P, Elliott M, Roland M. The GP
Patient Survey for use in primary care in the National Health Service in
the UK—development and psychometric characteristics. BMC Fam
Pract. 2009;10:57.

https://www.gp-patient.co.uk/

Household Pulse Survey United States Census Bureau (2023), Phase 3.7 Household Pulse
US Survey.
https://www.census.gov/programs-surveys/household-pulse-
survey/technical-documentation/questionnaires.2023.html#phase3.7

International Standard UNESCO Institute for Statistics (2011), International Standard

Classification of Education Classification of Education ISCED 2011
(ISCED)
International Physical Craig CL, Marshall AL, Sjostrom M, Bauman A, Booth ML, Ainsworth BE,
Activity Questionnaire - Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P: International Physical
Short Form (IPAQ-SF) Activity Questionnaire: 12-country reliability and validity. Medicine and
Science in Sports and Exercise. 2003, 35: 1381-1395.
Medicare Patient Parker JL, Regan JF, Petroski J (2014), Beneficiary activation in the
Engagement Questions Medicare population. Medicare & Medicaid Research Review, 4, E1-E14.

https://www.cms.gov/data-research/research/medicare-current-
beneficiary-survey

Mediterranean Household The European Union (2019), Mediterranean Household International

International Migration Migration Survey (MED-HIMS).
Survey (MED-HIMS)
National Health Interview Cohen RA, Cha AE (2023), Problems paying medical bills: United States,
Survey (NHIS) 2021.
NHS Inpatient Survey 2022 National Health Service, Care Quality Commission (2022), NHS inpatient
survey
OECD Measuring Financial OECD INFE (2011) Measuring Financial Literacy: Core Questionnaire in
Literacy Measuring Financial Literacy: Questionnaire and Guidance Notes for
conducting an Internationally Comparable Survey of Financial literacy.
42 

Paris: OECD.

OECD proposed Set of OECD (2018), OECD Health Working Papers No. 102.
Questions on Patient
Experiences with
Ambulatory Care
OECD Risks That Matter OECD (2018), OECD Risks That Matter Core Questionnaire.
Patient-Centered Medical Measures From the CAHPS Patient-Centered Medical Home Item Set.
Home (PCMH) Content last reviewed May 2017. Agency for Healthcare Research and
Quality, Rockville, MD.
https://www.ahrq.gov/cahps/surveys-guidance/item-
sets/pcmh/measures.html

Person-Centred Lloyd H, Fosh B, Whalley B, Byng R, Close J (2019), Validation of the

Coordinated Care person-centred coordinated care experience questionnaire
Experience Questionnaire (P3CEQ). International Journal for Quality in Health Care, 31(7), 506-
(P3CEQ)* 512.

*The P3CEQ is copyright [2018] University of Plymouth. All rights

reserved.
PISA-D Main Study Teacher OECD (2016) OECD PISA-D Main Study Teacher Questionnaire IS
Questionnaire IS
Porter-Novelli Consumer Maibach EW, Weber D, Massett H, Hancock GR, Price S (2006),
Preferences Scale Understanding consumers' health information preferences development
and validation of a brief screening instrument. Journal of health
communication, 11(8), 717-736.
Patient Reported Mounce L, Gangannagaripalli J, Ricci-Cabello I, Avery AJ, Valderas JM
Experiences and Outcomes (2017, October). Development of two short versions of the Patient
of Safety in Primary Care Reported Experiences and Outcomes of Safety in Primary Care
(PREOS-PC-6) (PREOS-PC) questionnaire: PREOS-PC compact and PREOS-PC-6.
Quality of Life Research (Vol. 26, No. 1, pp. 110-110).
PROMIS® Scale v1.2 – Available from https://www.promishealth.org/57461-2/
Global Health
PROMIS Adult Short Form Available from https://www.promishealth.org/57461-2/
v1.0 - Pain Interference
PROMIS Item Bank v. 1.0 – Available from https://www.promishealth.org/57461-2/
Dyspnea
UK National LGBT Survey Department of Education (2018), National LGBT Research Report.

Available from https://www.gov.uk/government/publications/national-

lgbt-survey-summary-report

Well-being questionnaire for OECD (2018), Well-being questionnaire for Pisa.

PISA 2018
WHO/ World Bank model- World Health Organization (2017) Model Disability Survey.
disability-survey
Available from https://www.who.int/publications/i/item/
9789241512862.

WHO Well-being Index Heun R, Bonsignore M, Barkow K, Jessen F (2001), Validity of the five-
(WHO-5) item WHO Well-Being Index (WHO-5) in an elderly population. European
archives of psychiatry and clinical neuroscience, 251, 27-31.