Understanding health care delivery as a complex system: achieving best possible health outcomes for individuals and communities by focusing on interdependencies

Abstract

Rationale, aims and objectives: The concept of emergence offers a new way of thinking about multimorbidity and chronic disease.

Results and conclusions: Multimorbidity and chronic disease are the end results of ongoing perturbations and interconnected activities of simpler substructures that collectively constitute the complex adaptive superstructure known as us, the person or patient. Medical interventions cause perturbations of many different subsystems within the patient, hence they are not limited to the person's bodily function, but also affect his general health perception and his interactions with his external environments. Changes in these domains inevitably have consequences on body function, and close the feedback loop of illness/disease, recovery and regained health.

Keywords: complexity in health; efficient and effective health system; health care reform; health systems reform; non-linear dynamics; patient-centred care; person-centred medicine.