Integrating patient complexity into health policy: a conceptual framework
Peter Maree
A B E , Roger Hughes A , Jan Radford C , Jim Stankovich A D and Pieter Jan Van Dam A
+ Author Affiliations
- Author Affiliations
A Tasmanian School of Medicine, College of Health and Medicine University of Tasmania, Private Bag 34, Hobart, Tas. 7001, Australia. Email: roger.hughes@utas.edu.au; pieter.vandam@utas.edu.au
B Department of Health, 22 Elizabeth Street, Hobart, Tas. 7000, Australia.
C General Practice, Tasmanian School of Medicine, College of Health and Medicine University of Tasmania, Private Bag 34, Hobart, Tas. 7001, Australia. Email: j.radford@utas.edu.au
D Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic. 3004, Australia. Email: jim.stankovich@monash.edu
E Corresponding author. Email: peter.maree@health.tas.gov.au
Australian Health Review 45(2) 199-206 https://doi.org/10.1071/AH19290
Submitted: 19 December 2019 Accepted: 19 June 2020 Published: 19 November 2020
Journal Compilation © AHHA 2021 Open Access CC BY-NC-ND
Abstract
Objective Clinicians across all health professions increasingly strive to add value to the care they deliver through the application of the central tenets of people-centred care (PCC), namely the ‘right care’, in the ‘right place’, at the ‘right time’ and ‘tailored to the needs of communities’. This ideal is being hampered by a lack of a structured, evidence-based means to formulate policy and value the commissioning of services in an environment of increasing appreciation for the complex health needs of communities. This creates significant challenges for policy makers, commissioners and providers of health services. Communities face a complex intersection of challenges when engaging with healthcare. Increasingly, complexity is gaining prominence as a significant factor in the delivery of PCC. Based on the World Health Organization (WHO) components of health policy, this paper proposes a policy framework that enables policy makers, commissioners and providers of health care to integrate a model of complexity into policy, subsequent service planning and development of models of care.
Methods The WHO components of health policy were used as the basis for the framework. Literature was drawn on to develop a policy framework that integrates complexity into health policy.
Results Within the framework, complexity is juxtaposed between the WHO components of ‘vision’, ‘priorities’ and ‘roles’.
Conclusion This framework, supported by the literature, provides a means for policy makers and health planners to conduct analyses of and for policy. Further work is required to better model complexity in a manner that integrates consumer needs and provider capabilities.
What is known about the topic? There is a growing body of evidence regarding patient complexity and its impact on the delivery of health services, but there is little consideration of patient complexity in policy, which is an important consideration for service provision.
What does this paper add? This paper presents an argument for the inclusion of patient complexity in health policy and provides a framework for how that might occur.
What are the implications for practitioners? The inclusion of patient complexity in policy could provide a means for policy makers to consider the factors that contribute to patient complexity in service provision decisions.
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