Taking the elderly with chronic diseases as the research object, the goal of this research is to enhance the management level of the elderly with chronic diseases in the mode of community-home endowment. The practice goal is to present a product service system of chronic disease management from the community health service institution. At the stage of data collection and analysis, the qualitative research is used to collect the user data. Personas are created to summarize existing issues. The user demands in the typical scenes are decomposed to work out the service demand and contents accordingly. As well, the types of service demand are allocated based on the results of KANO model. At the stage of service modelling, guided by the QFD and relevant theories, the house of quality is constructed to output the prioritized service features corresponding to the user demands, and an assessment thereof is conducted based on the design principle. The prioritized service features related to the chronic disease management in the context of community service are obtained by constructing the house of quality based on different types of user demands. In addition, the PSS design strategies for the elderly’s chronic disease management in communities are proposed.