Chinese study links IMEC knowledge to care preference

A cross-sectional study published in Supportive Care in Cancer examines the willingness of older patients with cancer in China to participate in Integrated Medical and Elderly Care (IMEC) and their preferences among four distinct service models. The research, conducted in Anhui Province, surveyed 924 patients aged 60 years and older to identify factors associated with their acceptance of and preference for these integrated care services. The study aims to address a critical gap between specialized cancer treatment and long-term elderly care, a challenge exacerbated by China’s large elderly population and the growing chronicity of cancer. By understanding these preferences, policymakers can better design targeted interventions to optimize integrated care delivery for this specific demographic.

The study utilized the Andersen Behavioral Model of Health Services Use to structure its investigation. This framework categorizes factors into predisposing, enabling, and personal need categories, which were assessed through a structured questionnaire. The primary outcome variables included the participants’ willingness to participate in IMEC, categorized as “no,” “depends,” or “yes,” and their preference for one of four service models: home-based, institution-based, community-based, or internet-based. The researchers employed descriptive analysis, univariable ordered logistic regression, and multivariable stepwise ordered logistic regression to identify factors associated with participation willingness. For model preference, chi-square tests and multivariable logistic regression were applied, with internet-based IMEC serving as the reference group.

Among the 924 participants, a significant portion expressed hesitation or refusal regarding IMEC participation. Specifically, 389 patients (42.1%) reported “no” willingness to participate, while 421 (45.6%) indicated that their decision “depends” on various factors. Only 114 patients (12.3%) reported a definitive “yes” to participation.

Several independent factors were identified as being associated with higher cumulative odds of being in a higher willingness category. Knowledge of IMEC was a significant predictor; patients who had heard of IMEC but were unfamiliar with it had an odds ratio of 2.099, while those who were familiar with it had an odds ratio of 3.332. Other factors included gait instability (OR = 1.801), primary cancer site, with gynecological cancer showing higher odds (OR = 3.157) and lymphoma showing lower odds (OR = 0.458). Economic and social factors also played a role, with pension as an income source (OR = 1.473), high social activity (OR = 1.753), having two children (OR = 1.459), access to recreation centers (OR = 1.404), and high life satisfaction (OR = 2.036) all associated with greater willingness to participate.

Regarding model preference, home-based IMEC was the most preferred option, selected by 57.5% of the participants. Institution-based IMEC followed with 20.2%, community-based with 18.2%, and internet-based with only 4.1%. The study found that familiarity with IMEC was associated with lower odds of preferring institution-based (OR = 0.282), community-based (OR = 0.331), and home-based (OR = 0.272) models compared to the internet-based reference group.

Economic affordability and specific cancer diagnoses also influenced model preference. Patients who perceived IMEC as highly affordable, defined as exceeding 280 USD per month, had higher odds of preferring community-based IMEC (OR = 5.373). In terms of cancer site, patients with breast cancer had lower odds of preferring community-based IMEC (OR = 0.147). Conversely, patients with other cancer sites had lower odds of preferring home-based (OR = 0.193) and community-based (OR = 0.199) IMEC.

The study concludes that knowledge of IMEC, health needs, and economic and social support are key factors associated with older cancer patients’ willingness to participate in these integrated services. Model preference is linked to knowledge, affordability, and primary cancer site. The study concludes that tailoring IMEC services based on these factors may help improve service acceptance and matching. This may better meet the holistic medical and care needs of older patients with cancer.

The study is a cross-sectional survey conducted in Anhui Province, China.

Subject of Research: Factors influencing willingness to participate in and preference for Integrated Medical and Elderly Care models among older cancer patients in China

Article Title: Willingness to participate and model preference for integrated medical and elderly care among older patients with cancer in China: a cross sectional study

Article References: Wu, X., Huang, Z., Shi, Z., Chen, L., Song, L., & Huang, J. (2026). Willingness to participate and model preference for integrated medical and elderly care among older patients with cancer in China: a cross sectional study. Supportive Care in Cancer, 34(12), Article 1204. https://doi.org/10.1007/s00520-026-11382-7

Image Credits: AI Generated

DOI: 10.1007/s00520-026-11382-7

Keywords: Integrated Medical and Elderly Care, Cancer care, Older adults, Health services use, China, Cross-sectional study, Patient preference, Anhui Province, Willingness, participate, model, preference