Objective We aimed to assess the effects of health status and living arrangements on long-term care models (LTCM) among the elderly of Xiamen,China, especially their cumulative joint effects.Methods We enrolled 14,373 participants aged 60+ years by multistage sampling across 173 communities in Xiamen, China, in 2013.Odds ratios (ORs) were estimated by multinomial logistic regression regressing LTCM on health status and living arrangements, adjusting by some covariates, and using the Anderson model as theoretical framework for analysis.Chi-squares tests and multiple logistic regressions were used to identify factors associated with LTCM.Results Totally, 14,292 (99.44%) valid questionnaires were obtained in the end, of which 86.37% selected home care, and "completely independentand "living with children and spousetook up the greatest proportion (69.5% and 34.9%, respectively).With the increase of disability degree, older people are more likely to choose institutional care, compared to living alone (ORs=1.75, 2.06,4.00, 4.01 for the "relatively independent, "mild disability, "moderate disability,and "total disability, respectively, in comparison with "completely independent).The old-age living with children and other family members preferred to choose home care.(ORs=0.50, 0.39, 00.40, and 0.43 for the "living with children, "living with spouse, "living with children and spouse, and "living with others, respectively, in comparison with "alone).Moreover, residence, number of children, education level, whether suffering from chronic diseases and loneliness affected both the pension community and institutional care choices.Conclusion A multitude of older people are inclined to choose home-based care in Xiamen, due to the influence of Chinese traditional culture.Health status and living arrangements are significantly associated with LTCM controlling for other covariates using multinomial logistic regression.And there was an interaction and joint effect between the degree of disability and the living arrangements on LTCM.