--- title: "Complexity in the care of pts with chronic conds. | Sutter Health" description: "The AHRQ Multiple Chronic Conditions (MCC) Research Network developed a conceptual model to guide research of effective healthcare for pts with MCC." url: "https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Complexity in the care of pts with chronic conds. # A conceptual model of the role of complexity in the care of patients with multiple chronic conditions. Grembowski D, Schaefer J, Johnson KE, Fischer H, Moore SL, Tai-Seale M, Ricciardi R, Fraser JR, Miller D, & LeRoy L; AHRQ MCC Research Network. _Med Care. 52 Suppl 3:S7-S14. doi: 10.1097/MLR.0000000000000045._ 2014-03-01 ## Abstract BACKGROUND: Effective healthcare for people with multiple chronic conditions (MCC) is a US priority, but the inherent complexity makes both research and delivery of care particularly challenging. As part of AHRQ Multiple Chronic Conditions Research Network (MCCRN) efforts, the Network developed a conceptual model to guide research in this area. OBJECTIVE: To synthesize methodological and topical issues relevant to MCC patient care into a framework that can improve the delivery of care and advance future research about caring for patients with MCC. METHODS: The Network synthesized essential constructs for MCC research identified from roundtable discussion, input from expert advisors, and previously published models. RESULTS: The AHRQ MCCRN conceptual model defines complexity as the gap between patient needs and healthcare services, taking into account both the multiple considerations that affect the needs of MCC patients, as well as the contextual factors that influence service delivery. The model reframes processes and outcomes to include not only clinical care quality and experience, but also patient health, well being, and quality of life. The single-condition paradigm for treating needs one-by-one falls apart and highlights the need for care systems to address dynamic patient needs. CONCLUSIONS: Defining complexity in terms of the misalignment between patient needs and services offers new insights in how to research and develop solutions to patient care needs. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/24561762) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Research Aimed at Improving Both Mood and Weight (RAINBOW) in Primary Care: A Type 1 hybrid design randomized controlled trial.](https://www.sutterhealth.org/research/publications/research-aimed-at-improving-both-mood-and-wt-1055312852) Ma J, Yank V, Lv N, Goldhaber-Fiebert JD, Lewis MA, Kaye Kramer M, Snowden MB, Rosas LG, Xiao L, Blonstein AC. Contemp Clin Trials. 43:260-78. doi: 10.1016/j.cct.2015.06.010. Epub 2015 June 19. 2015 Jul 01 - Publication ### [The Electronic CardioMetabolic Program (eCMP) for patients with cardiometabolic risk: a randomized controlled trial.](https://www.sutterhealth.org/research/publications/electronic-cardiometabolic-program-1055312305) Azar KM, Koliwad S, Poon T, Xiao L, Lv N, Griggs R, Ma J. J Med Internet Res. 18(5):e134. doi: 10.2196/jmir.5143. 2016 May 27 - Publication ### [Behavioral weight loss and physical activity intervention in obese adults with asthma: a randomized trial.](https://www.sutterhealth.org/research/publications/behavioral-weight-loss-in-obese-asthmatic-adults-1055312842) Ma J, Strub P, Xiao L, Lavori PW, Camargo CA Jr, Wilson SR, Gardner CD, Buist AS, Haskell WL, Lv N. Ann Am Thorac Soc. 12(1):1-11. doi: 10.1513/AnnalsATS.201406-271OC. 2015 Jan 01 - Publication ### [The effectiveness of two community-based weight loss strategies among obese, low-income US Latinos.](https://www.sutterhealth.org/research/publications/community-wt-loss-programs-for-obese-latinos-1055312788) Rosas LG, Thiyagarajan S, Goldstein BA, Drieling RL, Romero PP, Ma J, Yank V, Stafford RS. J Acad Nutr Diet. pii: S2212-2672(14)01589-5. doi: 10.1016/j.jand.2014.10.020. \[Epub ahead of print\] 2015 Jan 08 - Publication ### [Adult obesity and office-based quality of care in the United States.](https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917) Ma J, Xiao L, Stafford RS. Obesity. 17(5):1077–1085. 2009 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Complexity in the care of pts with chronic conds."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633#medicalscholarlyarticle","name":"A conceptual model of the role of complexity in the care of patients with multiple chronic conditions.","headline":"Complexity in the care of pts with chronic conds.","abstract":"BACKGROUND: Effective healthcare for people with multiple chronic conditions (MCC) is a US priority, but the inherent complexity makes both research and delivery of care particularly challenging. As part of AHRQ Multiple Chronic Conditions Research Network (MCCRN) efforts, the Network developed a conceptual model to guide research in this area. OBJECTIVE: To synthesize methodological and topical issues relevant to MCC patient care into a framework that can improve the delivery of care and advance future research about caring for patients with MCC. METHODS: The Network synthesized essential constructs for MCC research identified from roundtable discussion, input from expert advisors, and previously published models. RESULTS: The AHRQ MCCRN conceptual model defines complexity as the gap between patient needs and healthcare services, taking into account both the multiple considerations that affect the needs of MCC patients, as well as the contextual factors that influence service delivery. The model reframes processes and outcomes to include not only clinical care quality and experience, but also patient health, well being, and quality of life. The single-condition paradigm for treating needs one-by-one falls apart and highlights the need for care systems to address dynamic patient needs. CONCLUSIONS: Defining complexity in terms of the misalignment between patient needs and services offers new insights in how to research and develop solutions to patient care needs.","description":"The AHRQ Multiple Chronic Conditions (MCC) Research Network developed a conceptual model to guide research of effective healthcare for pts with MCC.","keywords":["Cardiovascular Diseases","Disease Management","Health Services","Mental Health","Obesity"],"datePublished":"2014-03-01","url":"https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"24561762"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1097/MLR.0000000000000045"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/24561762/","https://doi.org/10.1097/MLR.0000000000000045"],"isPartOf":{"@type":"Periodical","name":"Med Care"},"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Cardiovascular Diseases","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Cardiovascular+Diseases%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Disease Management","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Disease+Management%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Mental Health","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Mental+Health%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Obesity","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Obesity%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633#breadcrumblist"}}} ```