The hierarchical allocation and spatial organization of medical resources in metropolitan regions have emerged as critical challenges for regional integration, particularly in addressing the disparities between administrative boundaries and actual healthcare-seeking patterns. This study employs an innovative methodology integrating mobile phone signaling data with hospital service hierarchy analysis to investigate cross-boundary medical travel within the Wuhan Metropolitan Area (WMA). Through systematic classification of 505 medical institutions into four tiers based on service coverage (provinciallevel: 2; metropolitan-level: 13; municipal-level: 198; county-level: 292), combined with analysis of 943, 872 cross-city medical trips in 2020, the research reveals fundamental characteristics of inter-jurisdictional healthcare mobility. Hospital service hierarchy analysis demonstrates significant spatial disparities in resource distribution. Provincial-level hospitals (Tongji Hospital and Union Hospital affiliated with Huazhong University of Science and Technology) serve 80% of townships but account for only 3.12% of total service capacity, with 22% of their patients originating from outside Wuhan. Municipal-level hospitals show uneven distribution, concentrated in Wuhan (133 of 198), while Xianning possesses only 2 such facilities despite its demographic significance. County-level institutions, though numerically dominant (292), handle merely 26.24% of total demand, with 96% of townships generating less than 0.1% demand for these facilities. Cross-city medical flows exhibit distinct spatial patterns. Wuhan dominates as the primary destination, receiving 42.04% of total cross-city trips, particularly from Ezhou (25.23% of Ezhou's outflow) and Xiaogan. Ezhou demonstrates the highest cross-city medical dependency (41.2% outflow rate), predominantly directed to Huanggang, Huangshi, and Wuhan. Conversely, Xianning’ limited municipal-level hospital resources correlate with substantial centripetal flows to Wuhan (89.9% of Xianning’s total outflow). The “Wuhan-Ezhou-Huanggang-Huangshi” corridor accounts for 63.7% of total metropolitan-level medical interactions, confirming core-periphery dynamics in healthcare accessibility. Transportation mode analysis reveals road dominance (90% of trips), with peripheral townships showing higher road dependency (355 townships >95% road usage). Rail transportation proves marginal (maximum 53% in 25 townships), concentrated along Wuhan-Xiaogan (10.2% rail share) and Wuhan-Ezhou-Huangshi corridors (8.7%), while other rail-connected corridors like Wuhan-Tianmen-Qianjiang show minimal medical utilization (2.1%). Spatial disparities in travel metrics emerge starkly: urban core townships average 20km/30min trips versus peripheral areas exceeding 100km/120min, with 26 edge townships enduring >60km journeys. Geographically Weighted Regression (GWR) analysis uncovers multi-scale influencing mechanisms. The model for total cross-regional medical trips achieves high explanatory power (R2 =0.92), identifying significant negative correlations with population density (β =-1.7487) and distance to municipal centers (β=-0.1696). This confirms that sparsely populated areas distant from urban cores generate higher cross-boundary demand. Travel duration analysis (R2 =0.72) demonstrates positive associations with distances to municipal (β=0.1885) and county centers (β=0.4314), revealing compounded accessibility challenges for rural populations. Contrary to expectations, transportation infrastructure metrics (rail station proximity, trunk road density) show insignificant impacts on travel time. The study identifies three critical mismatches: 1) Spatial concentration of high-tier hospitals in Wuhan createsimbalanced demand pressures, with provincial-level facilities absorbing 22% non-local patients; 2) Administrative boundary proximity intensifies cross-city flows, as 317 border townships exhibit >90% municipal-level hospital dependency; 3) Transportation infrastructure development fails to alleviate rural accessibility gaps, evidenced by persistent long-duration trips in 26 peripheral townships despite rail availability. Methodological limitations stem from data constraints, the absence of individual socioeconomic attributes restricts analysis of hospital selection mechanisms, while service capacity metrics lack clinical outcome dimensions. Future research should integrate electronic medical records with mobility data to capture decision-making processes and service quality influences. These findings necessitate strategic interventions: strengthening municipal-level hospital capabilities in underserved regions like Xianning; optimizing referral networks along high-flow corridors; and implementing targeted transportation-medical integration in peripheral zones with travel durations exceeding 60 minutes. The research demonstrates that metropolitan medical integration requires transcending administrative divisions through evidence-based resource allocation aligned with actual patient mobility patterns, providing a replicable framework for regional healthcare planning in developing contexts.