As the aging trend intensifies, the Chinese government prioritizes technological innovation in smart elderly care services to enhance quality and efficiency, catering to the diverse needs of the elderly. This study examines the acceptance and usage behavior of smart elderly care services among elderly individuals in Xi’an, using a modified Unified Theory of Acceptance and Use of Technology (UTAUT) model that includes digital literacy as a moderating variable. Data were collected via a survey of 299 elderly individuals aged 60 and above in Xi’an. The study aims to identify factors influencing the acceptance and usage behavior of smart elderly care services and to understand how digital literacy moderates the relationship between these factors and usage behavior. Regression analysis assessed the direct effects of Performance Expectancy (PE), Effort Expectancy (EE), Social Influence (SI), and Facilitating Conditions (FC) on usage behavior. These dimensions were then integrated into a comprehensive index Service Acceptance to evaluate their overall impact on usage behavior, with behavioral intention examined as a potential mediating variable. Results indicate that EE and SI significantly impact the adoption of smart elderly care services, whereas PE and FC do not. Behavioral intention mediates the relationship between these variables and usage behavior. Additionally, gender, age, and digital literacy significantly moderate the impact of service acceptance on usage behavior. This study provides valuable theoretical and practical insights for designing and promoting smart elderly care services, emphasizing the importance of usability and social promotion to enhance the quality of life for the elderly.

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