提高统筹层次是深化医药卫生体制改革的发展要求,有利于提高医疗保险的公平和效率。本研究以湖北省宜昌市为例,探讨现行新型农村合作医疗“县管县办”运行模式存在的问题,分析进行市级统筹的必要性和可行性,提出针对宜昌市现实情况的具体市级统筹实施建议,为其他省市进行下一步新型农村合作医疗改革提供参考资料。 To improve the level of overall planning is to deepen the requirements of the reform of the medical and health system and to improve the fairness and efficiency of medical insurance. In this study, Yichang City, Hubei Province as an example, to explore the existing new rural cooperative medical system “county management ” operating mode of the existing problems, analysis of the necessity and feasibility of municipal co-ordination, proposed for the reality of Yichang City specific Municipal co-ordinate the implementation of the recommendations for other provinces and cities for the next step new rural cooperative medical reform to provide reference materials.