Objective:To prompt prefecture level governments make good use of the policy tool of the share of out-of-pocket payment in total health expenditure, and scientifically measure the equity of regional health financing and the burden of medical treatment on the public. Methods: By using graphical method, the composition and relationship between personal health expenditure and out-of-pocket payment were listed. The reason why local investigation teams were unable to disclose out-of-pocket payment was identified through interviews. Results: There are difficulties in calculating total health expenditure at the prefecture level, which are different from national and provincial accounting. Conclusion: It is very necessary for prefecture level governments to improve their rational cognition and provide necessary organizational, technical, and personnel supports for accounting work.