Max Rady College of Medicine

Term: Patient Complexity

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Glossary Definition

Last Updated: 2016-11-15


In some cases, patients present with an interconnected and diverse set of needs. While some of these needs may be adequately dealt with by the healthcare system, other needs fall outside of its purview. When the treatment of health-related needs is confounded by the kinds of needs the healthcare system cannot address, patients are left dissatisfied with their experience and, ultimately, inadequately treated. Patients with these kinds of needs are often called "complex" (Johnson, 2013; Schaink et al., 2012).

In a review conducted by Schaink et al. (2012), they identified three dimensions of patient complexity: multimorbidity, resource utilization, and psychosocial. The multimorbidity dimension includes multiple diagnoses (multimorbidity), polypharmacy (multiple prescription medications), loss of physical functioning, and limited application of clinical practice guidelines. The resource utilization dimension includes heavy utilization of healthcare resources, costly care, self-management challenges, poor quality of life, and difficultly with healthcare system navigation. The psychosocial dimension includes poor mental health, low socio-economic status, poor social support, negatively affected relationships, caregiver strain and burnout, and demographic factors, such as age and sex (Schaink et al., 2012).

In Katz et al. (2016), the social complexities examined are similar in kind to the psychosocial dimension to patient complexity presented in Schaink et al. (2012). For more information on the conditions associated with social complexity investigated in Katz et al. (2016), please read the Social Complexities / Social Complexity Index concept.

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  • Johnson R. Do "complex needs" need "complex needs services"? - part one. Mental Health and Social Inclusion 2013;17(3):127-134.(View)
  • Katz A, Valdivia J, Chateau D, Taylor C, Walld R, McCulloch S, Becker C, Ginter J. A Comparison of Models of Primary Care Delivery in Winnipeg. Winnipeg, MB: Manitoba Centre for Health Policy, 2016. [Report] [Summary] [Additional Materials] (View)
  • Schaink AK, Kuluski K, Lyons RF, Fortin M, Jadad AR, Upshur R, Wodchis WP. A scoping review and thematic classification of patient complexity: Offering a unifying framework. Journal of Comorbidity 2012;2(1):1-9. [Abstract] (View)

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Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
Winnipeg, MB R3E 3P5 Canada