Objective  To investigate the satisfaction to care service and impact factors of pension institution selection among the elderly dwelling in institutions with different patterns of integrated medical and nursing care service and to provide evidences for the establishment of endowment patterns integrating medical and nursing care and adapting to regional economic and social development for dealing with population aging in China.

  Methods  Using stratified multi-stage sampling, we conducted a questionnaire survey and focus interview among 850 dwellers aged ≥ 60 years and living in 19 institutions with integrated medical and nursing care more than 6 months in 7 districts in Qingdao city between June 2017 and March 2018. Information on demographics, health status, self-care ability, daily life conditions, and medical and nursing care services were collected and analyzed.

  Results  Among the 800 participants with valid responses, 455 (56.88%), 121 (15.13%), and 224 (28.00%) reported that they would select the pension institution mainly providing nursing care, medical care, and both nursing and medical care services, respectively. No linear correlation between the overall satisfaction to service provided by the institutions and gender, age, disease condition among the participants reporting different selections of endowment institution (all P > 0.05). The overall satisfaction to the received care service was significantly correlated with household registration type for the participants selecting an institution mainly providing nursing care (P < 0.05), reversely with education, marital status, and score of activities of daily living (ADL) for the participants selecting an institution mainly providing medical care (all P < 0.05), and positively with family monthly income per capita and reversely with ADL score for the participants selecting an institution providing both nursing and medical care (both P < 0.05). Multivariate logistic regression results revealed that self-care ability, the most concerned endowment-related issues, age, and disease condition were significant influencing factors for the selection of institutions providing integrated medical and nursing care service (P < 0.05 for all).

  Conclusion  The elderly people with poor self-care ability, with great concern on health status or daily life care, aged ≥ 80 years, and suffering from a disease are more likely to select endowment institutions mainly providing medical care. Medical care, health management, and rehabilitation nursing need to be improved in institutions providing integrated medical and nursing care services.