Definition of patient complexity in adults: A narrative review.

Details

Serval ID
serval:BIB_33DB56C80279
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Definition of patient complexity in adults: A narrative review.
Journal
Journal of multimorbidity and comorbidity
Author(s)
Nicolaus S., Crelier B., Donzé J.D., Aubert C.E.
ISSN
2633-5565 (Electronic)
ISSN-L
2633-5565
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
12
Pages
26335565221081288
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
Better identification of complex patients could help to improve their care. However, the definition of patient complexity itself is far from obvious. We conducted a narrative review to identify, describe, and synthesize the definitions of patient complexity used in the last 25 years.
We searched PubMed for articles published in English between January 1995 and September 2020, defining patient complexity. We extended the search to the references of the included articles. We assessed the domains presented in the definitions, and classified the definitions as based on (1) medical aspects (e.g., number of conditions) or (2) medical and/or non-medical aspects (e.g., socio-economic status). We assessed whether the definition was based on a tool (e.g., index) or conceptual model.
Among 83 articles, there was marked heterogeneity in the patient complexity definitions. Domains contributing to complexity included health, demographics, behavior, socio-economic factors, healthcare system, medical decision-making, and environment. Patient complexity was defined according to medical aspects in 30 (36.1%) articles, and to medical and/or non-medical aspects in 53 (63.9%) articles. A tool was used in 36 (43.4%) articles, and a conceptual model in seven (8.4%) articles.
A consensus concerning the definition of patient complexity was lacking. Most definitions incorporated non-medical factors in the definition, underlining the importance of accounting not only for medical but also for non-medical aspects, as well as for their interrelationship.
Keywords
complex, complexity, multimorbidity, patient complexity
Pubmed
Open Access
Yes
Create date
31/05/2022 13:41
Last modification date
21/11/2023 8:11
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