{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:36:00Z","timestamp":1779885360539,"version":"3.53.1"},"reference-count":27,"publisher":"CSIRO Publishing","issue":"3","license":[{"start":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T00:00:00Z","timestamp":1755302400000},"content-version":"vor","delay-in-days":1654,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,28]]},"abstract":"<jats:p>The aim of this study was to present the health and social characteristics of community-dwelling older people within the Cairns region who were identified by their GP as having complex care needs. This paper reports the subanalysis of baseline data from the Older Persons Enablement and Rehabilitation (OPEN ARCH) stepped wedge randomised controlled trial of an integrated model of care for community-dwelling older people. Data were analysed at the level of the participant and the level of the participant cluster (group of participants from the one GP). Median quality of life, as assessed by the EQ-5D, was higher for females than males (80 vs 70 respectively; P = 0.05) and for people living alone than living with family (80 vs 60 respectively; P = 0.0940). There was greater functional independence among non-Indigenous than Indigenous participants (median Functional Independence Measure scores of 122 vs 115 respectively; P = 0.0937) and the incidence rate (95% confidence intervals) of presentation to the emergency department was sevenfold higher for Indigenous than non-Indigenous participants (11.47 (5.93\u201320.03) vs 1.65 (0.79\u20133.04) per 1000 person days respectively). Finally, 61.3% of participants required support to remain living in the community and 44% accessed allied health, with podiatry the most common intervention. The findings indicate that previous hospital utilisation is not a consistent indicator of complexity. Multimorbidity, cultural context and the living and caring situation are considered as matters of complexity, yet variation exists at the participant level.<\/jats:p>","DOI":"10.1071\/py20125","type":"journal-article","created":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T18:15:54Z","timestamp":1612376154000},"page":"194-201","source":"Crossref","is-referenced-by-count":7,"title":["Beyond multimorbidity: primary care and the older person with complex needs"],"prefix":"10.1071","volume":"27","author":[{"given":"Jennifer","family":"Mann","sequence":"first","affiliation":[{"name":"ACairns and Hinterland Hospital and Health Service, PO Box 906, Cairns, Qld 4870, Australia."},{"name":"BCollege of Public Health, Medicine and Veterinary Sciences, James Cook University, Townsville, Qld 4811, Australia."},{"name":"ECorresponding author. Email: jennifer.mann@my.jcu.edu.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fintan","family":"Thompson","sequence":"additional","affiliation":[{"name":"BCollege of Public Health, Medicine and Veterinary Sciences, James Cook University, Townsville, Qld 4811, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9943-9384","authenticated-orcid":true,"given":"Rachel","family":"Quigley","sequence":"additional","affiliation":[{"name":"ACairns and Hinterland Hospital and Health Service, PO Box 906, Cairns, Qld 4870, Australia."},{"name":"CCollege of Medicine and Dentistry, James Cook University, Townsville, Qld 4811, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn","family":"McDermott","sequence":"additional","affiliation":[{"name":"DDivision of Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Devine","sequence":"additional","affiliation":[{"name":"BCollege of Public Health, Medicine and Veterinary Sciences, James Cook University, Townsville, Qld 4811, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Strivens","sequence":"additional","affiliation":[{"name":"ACairns and Hinterland Hospital and Health Service, PO Box 906, Cairns, Qld 4870, Australia."},{"name":"CCollege of Medicine and Dentistry, James Cook University, Townsville, Qld 4811, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"2025102822171270800_R1","unstructured":"Agency for Clinical Innovation (2014) Building partnerships: a framework for integrating care for older people with complex health needs. 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