The following is a summary of “Advancing Health Equity for Indigenous Peoples in Canada: development of a patient complexity assessment framework,” published in the April 2024 issue of Primary Care by Sehgal et al.

Indigenous patients frequently manifest complex health needs within clinical contexts, reflecting the historical legacies of colonization. However, healthcare systems and providers often lack the tools to discern underlying causes or implement effective solutions for this complexity. This study developed an Indigenous-centered patient complexity assessment framework tailored to urban Indigenous patients in Canada. Employing a multi-phased approach, the research commenced with a comprehensive literature review on complexity, followed by in-depth interviews with Indigenous patients to capture their nuanced lived experiences of complexity. 

Subsequently, a modified e-Delphi consensus-building process engaged a panel of 14 healthcare experts specializing in Indigenous health to discern the domains and concepts constituting health complexity, thereby informing the Indigenous-centered framework. This study delineates the final phase of this comprehensive research endeavor. The resultant framework encompasses 27 concepts distributed across nine domains: biological, social, health literacy, psychological, functional, healthcare access, adverse life experiences, resilience and cultural factors, and healthcare violence domains. This framework not only delineates critical indicators of health complexity among Indigenous patients but also furnishes healthcare providers with a valuable resource to enhance the quality and cultural competence of care delivery to Indigenous communities. 

Furthermore, this framework contributes to the scholarly landscape by introducing domains not typically encompassed in existing patient complexity assessment tools, extending their applicability and potentially mitigating the systemic inequities and racism experienced by marginalized populations, including Indigenous peoples.

Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02362-z