In order to explore how to establish an effective public health and long-term health care system for the elderly in the Internet of Things environment, sustainable development of the public health system for the elderly in the Internet of Things environment was proposed. Through field research, the need of the elderly for home-based care can be divided into the following four categories: daily care, medical care, emergency care, and emotional care. Through the key technical problems and solutions of information recommendation represented by the Internet of Things, we explored the research on how to establish the elderly care system. Existing research shows that nearly 90% of the elderly chose their own home or their children’s to provide care for the elderly, while the proportion of rural elderly who chose family members to provide care for the elderly reaches 97%. However, as an important supplement to family support, the acceptance of institutional support in the public is not optimistic; among them, the overall proportion of the elderly who favored nursing homes as providers for elderly care in the future was less than 5%, and the willingness and attitude of the rural elderly regarding the institutional elderly care model were more disapproving, with only 1.44% of them recognized. Therefore, sustainable development in the Internet of Things environment is not only a key measure to effectively solve the mismatch between supply and demand of elderly care services, but also a favorable exploration for information technology to play an important role in the field of public services.