The development of primary healthcare facilities facilitates a balanced distribution of medical resources, relieving pressure on large hospitals by enhancing these facilities, thus optimizing resource allocation. Such equitable distribution not only improves the accessibility and fairness of healthcare services, but also supports their sustainable growth. This study introduces a spatial resilience framework that evaluates transmission, diversity, and stability from a spatial resilience perspective. Focusing on Harbin's main urban area's primary healthcare facilities, methods such as Gaussian-Based Two-Step Floating Catchment Area (2SFCA), network analysis-based service radius, walking impedance, and overlap analysis are utilized for spatial distribution analysis. Findings indicate significant variance in facility transmission, with Daoli, Nangang, and Xiangfang Districts showing higher accessibility, Songbei and Daowai Districts exhibiting lower transmission. The road network capacity decreases from the urban center towards the periphery in a diminishing pattern. Local Indicators of Spatial Association (LISA) identifies areas with demand-supply mismatches, primarily in northern Xiangfang District and southern Songbei District, while overall spatial connection remains balanced. Based on these findings, we propose strategic enhancements for medical facilities of corresponding levels, offering insights for similar large cities seeking to refine their primary healthcare spatial layout.