Its true that MAME can be configured for "AND" combinations of keys. But there are limitations to this.
For example if you replicate the I-PAC shift combination Start1 + P1SW1 = coin, as soon as you press the Start1 button the game will try to start because the "primary" key is sent, then the shifted "coin" key will be sent.
This does not happen using the I-PAC method, the primary key is not sent, only the shift combination key.
This does not cause issues with some key combinations but does with others.