Dual-Network Integration in a County-Level Medical Consortium: An Exploratory Case Study from Yilong, an Underdeveloped Region

Objective This study explores the operational mechanism and policy efficacy of the ‘county-township linkage + village doctor embedding’ dual-network integration model in addressing the ‘last mile’ challenge in primary healthcare within underdeveloped regions. Methods Employing a longitudinal, embedded single-case design, this research analyses the reform trajectory in Yilong County, Sichuan Province, from 2018–2024. Multisource qualitative and quantitative data, including policy documents, stakeholder interviews, field observations, and institutional operational records, were triangulated to ensure robustness. Results The findings reveal a synergistic governance mechanism. The county-township linkage constructs a vertically integrated professional network through unified governance, resource pooling, and service standardisation. Concurrently, village doctor embedding activates a community-based service network via a four-dimensional framework encompassing management, operational, functional, and developmental embedding. This dual-network integration effectively bridges systemic accountability with community-based social capital, leading to marked improvements in healthcare accessibility and the retention of patients within the local tiered system. Conclusions Integrating the principles of accountable care organisation theory and social capital theory, this model provides a replicable micromechanism for primary care reform in resource-constrained settings. Its successful application hinges on context-adaptive refinements, particularly in health-outcome-oriented financing and institutional support for the frontline workforce. The study contributes a viable governance blueprint for strengthening integrated care in underdeveloped regions, with implications for both national policy and global health equity initiatives.