Current Developments in Delivering Customized Care: A Scoping Review

Abstract

Background In recent years, there has been a growing interest in healthcare personalization and customization (e.g. personalized medicine and patient-centered care). While some positive impacts of these approaches have been reported, there has been a dearth of research on how these approaches are implemented and combined for healthcare delivery systems. Objective The present study undertakes a scoping review of current developments for delivering customized care, according to theoretical and practical guidelines for customization delivery approaches. Methods Article searches were initially conducted in November 2018, and updated in January 2019 and March 2019, according to Prisma guidelines. Two investigators independently searched MEDLINE, PubMed, PyscINFO, Web of Science, Science Direct and JSTOR, The search was focused on articles that included “care customization”, “personalized service and healthcare”, individualized care” and “targeting population” in the title or abstract. Inclusion and exclusion criteria were defined. Disagreements on study selection and data extraction were resolved by consensus and discussion between two reviewers. Results We identified 70 articles published between 2008 and 2019. Most of the articles (n = 43) were published from 2016 to 2019. Four categories of patient characteristics used for segmentation analysis emerged: clinical, psychosocial, service and costs. We observed they often coexisted with the most commonly described combinations, namely clinical, psychosocial and service. A minority of articles (n = 18) reported assessments on quality of care, experiences and costs. Finally, few articles (n= 6) formally defined a conceptual basis related to mass customization, whereas only half of articles used existing theories to guide their analysis or interpretation. Conclusions There is no common theory based strategy for providing customized care. In response, we have highlighted three areas for researchers and managers to advance the customized development concept in healthcare delivery systems: better define the content of the segmentation analysis and the intervention steps, demonstrate its added value, in particular its economic viability, and align the logics of action that underpin current efforts of customization. It would allow them to use customization to reduce costs and improve quality of care.