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Hickam DH, Weiss JW, Guise JM, et al. Outpatient Case Management for Adults With Medical Illness and Complex Care Needs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Jan. (Comparative Effectiveness Reviews, No. 99.)

  • This publication is provided for historical reference only and the information may be out of date.

This publication is provided for historical reference only and the information may be out of date.

Appendix EDefining Complex Care Needs

SourceDescription/Definition
American Geriatrics SocietyPersons whose conditions require complex continuous care and frequently require services from different practitioners in multiple settings.
Robert Wood Johnson Foundation, Research Synthesis Report NO. 19 (12/2009): Care management of patients with complex care needsUsually patients who are Medicare beneficiaries with multiple chronic conditions, frequent hospitalizations, and limitations on their ability to perform basic daily functions due to physical, mental and psychosocial challenges. Patients with complex health care are patients at the far end of a population-wide spectrum ranging from health individuals to people with serious medical problems and high utilization of heath care services.
Scottish Executive, Department of Health Ministries (Report 2007)Terms linked to the concepts of ‘complex’ and ‘multiple’ needs and include: ‘multiple disadvantage’, ‘multiple disabilities’, ‘multiple impairment’, ‘dual diagnosis’, ‘high support needs’, ‘complex health needs’, and ‘multiple and complex needs.’ People identified as having multiple and complex needs may include:
  • People with mental health problems, including ‘severe and lasting’ problems
  • Those disadvantaged by age and transitions – young and older people
  • Those fleeing abuse and violence – mainly women and refugees
  • Those culturally and circumstantially disadvantaged or excluded – minority, ethnic groups; travelling people
  • People with a disability, including profound, severe or long term impairment or disability and those with sensory disabilities with ‘additional needs’
  • People who present challenging behaviors to services, for example in schools, within residential services/ hostels or in their own neighborhoods
  • People who are multiply disadvantaged by poverty, poor housing, poor environments or rural locations which mean they are distant from services
  • People who have a ‘dual diagnosis’ of mental ill health and substance misuse, or of other combinations of medically defined conditions.
  • People who are ‘marginal, high risk and hard to reach’, who may be involved in substance misuse, offending and at risk of exclusion
Cover of Outpatient Case Management for Adults With Medical Illness and Complex Care Needs
Outpatient Case Management for Adults With Medical Illness and Complex Care Needs [Internet].
Comparative Effectiveness Reviews, No. 99.
Hickam DH, Weiss JW, Guise JM, et al.

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