To assess the level of direct economic burden of gastric cancer and provide basis for optimizing the allocation of resources and formulating the appropriate payment mechanism for diseases. We collected the details of direct medical expenses for all patients with gastric cancer from January 1 to June 30， 2017 in the six counties based on the new rural cooperative provincial information system platform， and described the level of direct medical expenses， cost structure and compensation level.①Hospitalization rate of patients with gastric cancer was 0.04%and hospitalization expenses accounted for 1.42% of the total cost of hospitalization for participant.②The number of hospitalizations in county?level and provincial?level medical hospitals accounted for 46.90% and 41.56%， respectively.③The average cost of hospitalization for gastric cancer per patients was 11294.31 yuan. The higher the hospitalization level， the lower the cost for patients.④Drug and material costs accounted for 17.29% and 22.97% of the total cost of hospitalization for gastric cancer respectively. The higher the level of hospitalization， the lower the proportion of drug costs.⑤Theactual compensation ratio for hospitalization of gastric cancer patients was 63.81%， and the actual compensation ratio for the poor population （91.24%） was higher than that of the general population（60.03%）. strengthening the inpatient service capacity of gastric cancer at the county?level medical institutions and establishing an effective referral mechanism for progressive patients can effectively reduce the direct economic burden of gastric cancer.