Objective: To compare the change of out of pocket (OOP) expenditure before and after the new medical reform, and analyze the cause of leading to OOP reduction. Methods: 2000-2015 time series data was used to compare the changes of OOP, and compared the Chinese OPP with other country use the cross series data, analyzed the cause of leading to OOP reduction in the principal component analysis. Result: In time series the OOP as % of total expenditure on health (TEH) decreased significantly, but in cross series the OOP as % of TEH in China was higher than the upper middle income countries. Per GDP, under five mortality , proportion over 65 years were significant effective with the OOP as % of TEH. Conclusion: The OOP as % of TEH needs to further decrease. Reduce the residents’medical burden by the measures of accelerating the economic growth, strengthen the medical security system, increasing the investment of public health.