Reengineering The Unit:A Study On The Misplacement And Adaptive Deployment Of Rural Public Healthcare Resources

Since the 1990s,China’s rural areas,especially those in the central and western regions,have experienced large-scale cross-regional population movements,resulting in dramatic desolation within villages,and this phenomenon of village hollowing out has continued to this day,posing no small challenge to the provision of rural public services.County N in Shanxi Province,located in the central region of China,is also facing this dilemma of village hollowing out.Before 2017,the county’s rural primary health care services were caught in a serious imbalance,with misplaced public health care resources.However,since the launch of the three-year action plan for village health room construction in 2017,the county’s village health service level once jumped to the forefront of the province and was even selected as one of the first typical cases of national rural public services.This change makes the author ask:Faced with the same serious phenomenon of "hollowing out" of villages,how was County N able to turn the pre-reform state of misplaced medical resources into an adaptive deployment of resources?What is the operational logic behind this?Based on the local practice of rural health office reform in County N of Shanxi Province,this paper describes in detail the transformation process of the allocation of rural public medical resources in County N.The logic behind the allocation of resources is further analyzed through fieldwork and literature analysis.Ultimately,it was found that the reform of village health offices in villages within county limits in County N was mainly based on the approach of reengineering service units,i.e.,changing the past mode of public medical resource supply with administrative villages as service units and instead constructing cross-village service circles.At the same time,the medical resources within the service circle are concentrated and integrated into the central village,and the central village health office is established,and then its medical radiation function to the surrounding neighboring villages is brought into play to achieve a win-win situation in terms of efficiency and effectiveness.Specifically,the reengineering of medical service units can be divided into three aspects:first,reorganizing the service space to form a 30-minute medical and health service circle with "central village service covering villages";second,diversifying the main body to promote a medical service pattern led by the government,with medical groups as the core and villagers’ needs as the guide;third,integrating supporting Third,the integration of supporting resources,the formation of property rights collectivization,service specialization,management refinement of resource advantages.It is through the debugging of these three levels that the service order,service capacity and governance capacity within the public medical service unit are regenerated,ultimately realizing the adaptive deployment of public medical resources and the effective supply of public medical services.