ObjectiveIntegrated medical and elderly care is a practical step to implement and enhance the health and quality of elderly care. This paper aims to delve into the underlying relationships among factors influencing institutional utilization of integrated medical and elderly care services， promote the efficient service utilization of integrated medical and elderly care model in institutions， and achieve substantial progress in elderly care welfare. MethodsThrough literature review， questionnaire surveys， and expert interviews， 15 key factors influencing the utilization of integrated medical and elderly care services in elderly care institutions were identified and screened. The TISM model and MICMAC method were employed to establish the mechanism of the influencing factors of the utilization of integrated medical and elderly care services in elderly care institutions， and the dependence and driving force among the influencing factors were analyzed. ResultsOverlapping functions among government departments， unclear boundaries of powers and responsibilities， and a low degree of improvement and implementation of the policy were the core driving factors affecting institutional utilization of integrated medical and elderly care services. ConclusionThrough in-depth analysis of the interaction among various influencing factors， practical suggestions for improvement were proposed to build a three-dimensional collaborative intelligent governance mechanism， shape the new advantages of the self-construction of elderly care institutions， and provide strategic support for the optimization of integrated medical and elderly care services utilization in China.