2nd Edition of Public Health World Conference (PHWC) 2026

Abstract

Objectives: Population aging has increased the need for supportive healthcare services that help older adults and their families navigate complex medical systems. Medical visit accompaniment services have gradually emerged in urban China, yet their public acceptance remains limited and uneven. This study aimed to examine the factors associated with adult children’s willingness to use medical visit accompaniment services for their older parents in Nanjing, China, and to clarify how different service needs shape family decision-making in the context of age-friendly healthcare.

Methodology: A cross-sectional questionnaire survey was conducted among 638 adult children of older adults from 11 municipal districts in Nanjing. Based on the Theory of Planned Behavior, this study developed a structural equation model including basic support needs, emotional and dignity-related needs, health management needs, future expectations, and willingness to use medical visit accompaniment services. Amos 28.0 was used to test the model, estimate structural paths, and decompose direct and indirect effects. The analysis focused on identifying whether different types of service needs promoted or inhibited willingness to use such services.

Results: The findings showed that basic support needs were the strongest positive factor associated with willingness to use medical visit accompaniment services. Practical functions such as process assistance, registration support, medical information organization, price transparency, and privacy protection enhanced adult children’s acceptance of these services. By contrast, emotional and dignity-related needs and health management needs showed negative total effects on willingness to use. This suggests that current service provision has not yet fully met families’ expectations for humanistic companionship, dignity protection, chronic disease support, and continuous health management. Future expectations also played a mediating role, indicating that service decisions were influenced not only by immediate care needs but also by anticipated caregiving burden, parental attitudes, and social recognition.

Conclusions: Medical visit accompaniment services should be understood as part of an age-friendly healthcare support system rather than merely a market-based convenience service. Improving service standardization, strengthening trust and privacy protection, developing tiered service packages, and gradually integrating health management functions may help enhance service accessibility and acceptance among older adults and their families. These findings provide empirical evidence for optimizing supportive healthcare services in aging urban societies.