title: Understanding health care delivery as a complex system: achieving best possible health outcomes for individuals and communities by focusing on interdependencies.
abstract: OBJECTIVE
  The concept of emergence offers a new way of thinking about multimorbidity and chronic disease.
  
  
  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.
authors.affiliation: Departments of General Practice, Newcastle University-Newcastle, Newcastle, NSW, Australia.
authors.forename: Joachim
authors.initials: J
authors.lastname: Sturmberg
authors.forename: Holly J
authors.initials: HJ
authors.lastname: Lanham
mesh_terms: D002908:Chronic Disease / Q000628:therapy; D003153:Community Health Services / Q000458:organization & administration*; D032882:Comprehension; D003695:Delivery of Health Care / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D005260:Female; D018166:Health Care Reform; D006291:Health Policy; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D061214:Patient Safety; D018802:Patient-Centered Care / Q000458:organization & administration*; D010817:Physician-Patient Relations; D011050:Policy Making; D011787:Quality of Health Care; D016896:Treatment Outcome
keywords: complexity in health; efficient and effective health system; health care reform; health systems reform; non-linear dynamics; patient-centred care; person-centred medicine