Abstract: Objective To explore urban and rural Changsha residents' willingness to pay for basic medical insurance for their primary school children and the determinants of the willingness,and to provide references for making basic medical insurance policy for pupils.Methods Using stratified cluster sampling method,we studied familial decision makers'willingness to pay for basic medical insurance for their primary school childen among families of 1 507 urban and rural pupils from 23 primary schools in Changsha city.Descriptive analysis,univariate and multivariate logistic regression were used to analyze the determinants of the decision makers' willingness.Results Among the familial decision makers,84.5%(771/912)expressed their willingness to purchase residents' insurance for their children and among the decision makers expressing the willingness,32.2%(248/771)were willing to pay 40-59 RMB yuan for purchasing the insurance,19.8%(153/771)willing to pay 100-190 RMB yuan,13.4%(103/771)willing to pay 80-99 RMB yuan.Totally 50.3%(459/912)of the familial decision makers expected to pay less than 300 RMB yuan for minimum deduction of the insurance,16.2%(148/912)expected to pay a amount of money between 300 and 499 RMB yuan,11.4%(104/912)expected to pay between 500 and 699 yuan.There were 61.9%(565/912)of the decision makers expecting that the inpatient reimbursement should be up to 80 percent of the total expenditure.The results of multivariate logistic regression indicated that the decision makers' education level(odds ratioOR=1.83-3.05),occupation(OR=0.16)and the number of family members(OR=3.88-5.35)affected the decision makers' willingness.Conclusion The familial decision makers did not consider the specific situation of the their primary school children when they made their willingness to pay,and the decision makers expected to obtain maximum medical security with less investment.