| Objective Based on the situation about the operation status and the fiscal balance of the New-rural CMS of Gaolan County, Gansu Province , an analysis about the BOD of the peasants and it's influential factors were made , and some strategies and suggestions to reduce and control the BOD of the peasants were given, so as to put forward a series of appropriate treatment to maintain the smooth development of the New-rural CMS and improve health level of the rural residents and the equity utilization of health service , and provide a scientific foundation to further improve and develop the New-rural CMS.Methods Gaolan County in Gansu Province, a first group of new-rural CMS pilot county, was chosen as the investigation site. The related data about hospitalization expenses and reimbursement information of the peasants who have participated the New-rural CMS and statistics reporting about the fiscal balance of the New-rural CMS funds from 2005 to 2007 were chosen to calculate the BOD of the peasants in Gaolan County. At the same time some cases were randomly sampled at 1 % sampling rate from all medical records of the patients who were hospitalized in People's Hospital of Gaolan County in 2002. The approach of disease is referred to the 10th version International Classification of Disease standard (ICD-10).Results (1) Growth rate of the per capita net income of agricultural population in Gaolan County had exceeded 8% every year from 2005 to 2007. Average annual growth rate of the per capita net income of peasants was 10.72% over three years. Sexual proportion of investigation population was 1:1.67. Average age was 39.13±19.42 years old, and the 15-59 years old crowds accounted for 71.24 % of all investigation population.(2) Growth rate of link relative ratio of hospital days increased by 193.25 % in township hospital between 2005 and 2006. Hospital days of the hospitalized peasants who were covered in the New-rural CMS increased and showed the significance difference among three years(P<0.01). The hospital days of the peasants who hospitalized in the county hospitals was longer than other level hospitals in 2005, but the hospital days in township hospitals were longer than other level hospitals in 2006 and 2007.(3) Average annual growth rate of the New-rural CMS funds was 48.77% from 2005 to 2007, and the New-rural CMS fund was positive growth in consecutive years with an average annual growth rate of 35.14%. The amounts of funds were mainly compensated for severe and acute patients who were hospitalized at or above the county hospitals from 2005 to 2007. During three years, the highest level of reimbursement still happened in the township hospitals.(4) After implementing the New-rural CMS in People's Hospital of Gaolan County, direct disease economic burden of hospitalized peasants is heavy than before. As a result of the occurrence of disease, entire accumulation time loss of investigable objects reached 189173 days during three years, time loss of average inpatient was 17.93 days, and the biggest time loss was 121 days.(5) The total of hospitalized peasants' economic burden of disease was 23824725.65 Yuan of Gaolan County in three years. Economic burden of per disease was 2257.63±3811.70 Yuan. The disease with heaviest per capita economic burden included: tumor, endocrine nutrition metabolism disease and circulatory system diseases. The total of 15～44 year-old crowd's economic burden of disease was heaviest, but the 45～59 year-old crowd's per capita economic burden of disease was heaviest. Medical expenses both economic burden total amount and per capita economic burden of disease were highest in the provincial hospitals, and it was lowest in the township hospitals. The economic burden of disease within different level hospitals are not same (P<0.01). The higher level hospitals, the heavier economic burden of disease (P<0.01) within three years.Conclusions Gaolan County in Gansu Province is a pilot county of the New-rural CMS, which is also an national pilot work county of the New-rural CMS in China. Through various efforts, the coverage of the New-rural CMS was achieved to a higher level within short term, the New-rural CMS funds is implemented smoothly. Operating efficiency and service quality of county health service system were improved. The quality and capacity of the professional county health staff were increased. The capacity of health services of each level departments is improved. The implementation of the New-rural CMS lightens BOD of peasants to some certain extants. The New-rural CMS especially impacts on the supply of inpatient services and effectively guides peasants to receive appropriate health services. Hospitalized peasants who were covered in the New-rural CMS can use convenient basic health services. But the levels of reimbursement of the New-rural CMS funds are lower and the BOD of peasants who have participated in the New-rural CMS is heavier. So the reducing of BOD is not obvious. Peasant would bear high medical expenses if he had suffered serious disease. Government need to increase financial support and strengthen the supervision of medical institutions in order to solve the problem of prevent peasants' life burden caused by the disease. It's necessary to establish an operational and long-time growth mechanism of the New-rural CMS funds.
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