Background <p>This study addresses spatial disparities in rural healthcare by introducing the concept of edge village —communities where a misalignment between administrative boundaries and functional hospital service areas (HSAs) leads to prevalent cross-region healthcare-seeking. This concept, grounded in edge-effect theory, provides a novel perspective for analyzing healthcare resource mismatches.</p> Methods <p>Using Liannan Yao Autonomous County, Guangdong Province, as a case study, we employed complex network community detection to delineate HSAs and identify edge villages. An institution-behavior-space integrative framework was applied, combining literature analysis and field surveys to establish a multidimensional factor system. Key indicators were selected via Elastic Net regression, and their impact mechanisms were analyzed using mixed logit models.</p> Results <p>Edge villages were systematically identified, revealing significant misalignment between actual healthcare service areas and administrative divisions. Key factors driving cross-region healthcare-seeking included service accessibility, resource quality, and patient mobility patterns. The proposed framework effectively interprets spatial disparities through the lens of edge villages.</p> Conclusions <p>The edge village concept offers a new micro-analytic unit and a transferable framework for understanding rural healthcare misallocation. It provides policymakers with an evidence-based tool to pinpoint underserved areas and formulate tailored governance strategies, thereby improving resource allocation fairness and efficiency and fostering inclusive regional development.</p>