Objective: To analyze the effective governance model of the merged county medical community and provide governance ideas for the construction of the merged county medical community in other regions. Methods: It makes a descriptive analysis on the interest demands of the government, the merged county medical community and medical staffs from 2016 to 2020 , evaluates the effectiveness of the reform of medical community, and discusses the governance mechanism of Sanming model from the perspective of the integration of principal-agent theory and stewardship theory. Results: Through the integration of principal-agent theory and stewardship theory, it is found that there is a two-level entrustment relationship among the government, the merged county medical community and medical staff. Among these three, the housekeeping behavior decreases and the agency behavior increases. Conclusion : In order to realize the public welfare of medical services, the first-level entrustment relationship should actively promote the establishment of the entrustment-housekeeper relationship. On the basis of restricting the agency behavior of the merged county medical community through strict control methods, the merged county medical community should be given sufficient trust and power to stimulate the housekeeping behavior and subjective initiative; in the second-level entrustment relationship, the medical staff's public welfare goal motivation is the weakest, and strict supervision and restraint methods can better solve the agency problem due to target heterogeneity and information asymmetry.