Table 1. Select multicountry tools measuring population views on the health system in current use.
| Surveys (vary by country and wave) | Aim | Population | Mode | Sample size (per country) | Key domains | No. of items | No. countries in last wave | Income levels of survey countries | Year of last wave | Organization |
|---|---|---|---|---|---|---|---|---|---|---|
| People’s Voice Survey | To measure people’s health care use, experiences, and overall confidence in the health system; to hold health systems accountable and enable cross-national comparisons | All adults aged 18 and older | Phone survey; face-to-face household survey in areas of low phone penetration | 1,000–2,500 respondents | Health and demographics; Utilization of care and system competence; Care experience; Health system confidence | ~65 | 19 | High, middle, low | 2022–2023 | QuEST Network (https://questnetwork.org/peoples-voice-survey) |
| Service Provision Assessments | To assess service availability and quality of care within countries’ health systems at the facility level; to provide a snap-shot of the service environment, resources, and practices used to provide health services | Formal sector healthcare facilities (includes interviews and observations or providers and patient exit interviews) | In-person interviews and surveys interviewers | ~400 to 700 health facilities | Inventory (resources and equipment); Health worker qualifications/skills, clinical performance, services provided, in-service training, and work environment; Client experience | ~360 | 1 completed; 1 ongoing | Middle, low | 2021 | Demographic and Health Surveys Program, USAID (https://dhsprogram.com/Methodology/Survey-Types/SPA.cfm) |
| Demographic and Health Surveys | To provide nationally representative data on population, health, and nutrition | Households; in selected households, all women aged 15 to 49 years; may include male respondents aged 15 to 59 years | Household survey | ~5,000 to 30,000 households | Demographics and health and nutrition indicators (e.g., infant and child mortality, fertility, family planning use, maternal health, child immunization, malnutrition levels, HIV prevalence, and malaria) | ~467 items | 1 completed 2021; 16 ongoing in 2022 | Middle, low | 2021–2022 | Demographic and Health Surveys Program, USAID (https://dhsprogram.com/Methodology/Survey-Types/DHS.cfm) |
| International Health Policy Survey (2020 edition) | To compare the health experiences of adults with lower income during the pandemic and the effect of income-related disparities (e.g., health status, patient experience, barriers to care) | Noninstitutionalized adults aged 18 and older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, Sweden, the United Kingdom, and the United States | Landline and mobile phone interviews; online surveys in Sweden, Switzerland, and the United States | ~607 to 4,530 participants | Health status; Socioeconomic risk factors; Affordability of care; Access to care | ~130 | 11 | High | 2020 (more recent versions focused on older adults and health care providers) | Commonwealth Fund (https://www.commonwealthfund.org/publications/surveys/2020/dec/2020-international-survey-income-related-inequalities) |
| Consumer Assessment of Healthcare Providers and Systems (CAHPS): Clinician and Group Survey | Determine the need for improvement activities and evaluate their impact; Equip consumers with information to choose healthcare providers; Monitor the performance of providers and groups and reward them for high-quality care | Adults 18 years old or older, or children 17 years old or younger who had a visit with an individual provider, practice, or medical group | Mail, telephone, email, or mixed-mode protocols | Variable; typically requires 50 respondents per provider or 300 respondents per medical group | Patient experience of: Getting timely appointments, care, and information; How well providers communicate with patients; Providers’ use of information to coordinate patient care; Helpful, courteous, and respectful office staff; Patients’ rating of the visit/provider | 33 (Adult visit survey 4.0) | Developed for the United States; implemented in 6 countries in Europe | High | N/A (Independently conducted) | United States Agency for Healthcare Research and Quality (https://www.ahrq.gov/cahps/index.html) |
| Primary Care Assessment Tools (PCAT), Adult and Children Editions | To assess and assure the quality of primary care service delivery | Varies; Can include children, adults, health professionals, managers, and administrators | Mail surveys and telephone interviews | Varies | Patient subjective experience measures of: Accessibility; Utilization; Ongoing care; Coordination of services; Comprehensiveness of services available and received | Varies; 74 items in the original instrument | N/A (Independently conducted) | High, middle | 2021 (Brazil) | Johns Hopkins University (https://www.jhsph.edu/research/centers-and-institutes/johns-hopkins-primary-care-policy-center/pca_tools.html) |
| Patient-Reported Indicator Surveys (PaRIS): International Survey of People Living with Chronic Conditions | To measure the outcomes and experiences of healthcare that matter most to people | Primary care service users aged 45 years or older and providers | Online; Respondents can opt for a paper version | 2,500 | Subjective feelings of users about their health; Degree of decision-making involvement about their health; The extent to which chronic conditions limit participation in social activities; How outcomes and experiences vary with people from different socioeconomic background | 118 (User questionnaire); 40 (Provider questionnaire) | 21 (planned) | High | 2023 (planned) | Organisation for Economic Co-operation and Development (OECD) (https://www.oecd.org/health/paris/) |
| EUROPEP (European Task Force on Patient Evaluations of General Practice) | To measure patient evaluations of specific aspects of general practice care; To enable international comparison of general practice care in Europe. | Patients recruited from general practitioner practices | Mail survey | ~316–1,080 | Aspects of care: Relation and communication; Medical care; Information and support; Continuity and cooperation; Facilities, availability and accessibility | 23 | 20 (since inception) | High, middle | 2021 | European Society for Quality and Safety in Family Practice (https://equip.woncaeurope.org/tools/europep) |
Notes: The table includes multicountry surveys in current use that are purpose-built for assessing health system performance. It excludes opinion polls, ad hoc surveys and event-based polling, single-country surveys, and surveys of one aspect of health system functioning, such as National Health Accounts.