Comparing patient and healthcare professional preferences for patient-centered integrated care in China: a best-worst scaling study

Since 2016, China has implemented integrated care reforms to address service fragmentation. However, there is limited evidence regarding the preferences of key stakeholders for the various dimensions of integrated care. This study aims to quantify and compare the priorities of patients and healthcare professionals to inform the ongoing development of patient-centered integrated care in China. This study employed a best-worst scaling object case survey to evaluate 14 attributes derived from the validated Chinese Patient-Centered Integrated Care scale. In 2023, the survey was administered using distinct methods for each group: computer-assisted, face-to-face interviews for patients with chronic diseases, and a self-administered online survey for primary healthcare professionals. Each respondent completed 13 choice tasks, each containing seven attributes. Data were analysed using the counting approach and mixed logit models to estimate the relative importance (RI) of each attribute. The final analysis included 82 patients and 774 healthcare professionals. A fundamental divergence in preference structures was found. Patient preferences were highly concentrated, with RI scores ranging widely from 0.2% to 33.5%; ‘Accessibility of medicine’ (RI: 33.5%) and ‘Respectfulness’ (RI: 31.0%) were the highest priorities. In contrast, healthcare professional preferences were more balanced, with RI scores ranging from 3.6% to 11.7%; ‘Accessibility of technology’ (RI: 11.7%) and ‘Comprehensive care’ (RI: 11.5%) were most valued. Statistically significant preference heterogeneity was observed within each group, with factors such as age and gender identified as significant sources of variation. Patients and healthcare professionals in China hold fundamentally different priorities for integrated care. Patients prioritized medication access and humanistic aspects of care, whereas professionals prioritized technology access. These findings provide valuable evidence to guide the development of integrated care aligned with stakeholder needs, and future larger-scale, nationwide studies are needed to provide more robust evidence.