目的：以甲状腺恶性肿瘤为例分析杭州市单病种定额付费实施的效果及存在的问题。方法：利用方差分析、t检验和Mann-whitney非参数检验等统计学方法分析实施单病种定额付费前后患者次均费用、明细费用、平均住院日等数据的变化情况。结果：实施单病种定额付费后，患者次均费用下降3 566元，其中药费下降1 775元，下降幅度最为显著（P < 0.05）；Mann-whitney非参数检验结果显示平均住院日差别有统计学意义，实施单病种定额付费后平均住院日下降2.8天。结论：单病种定额付费实施后有效降低了甲状腺恶性肿瘤患者的医疗费用，减轻了患者的负担，建议制定科学合理的付费机制，将更多疾病纳入单病种定额付费管理。

Objective：To analyze the implementation effect and problems of the quota payment of specific diseases for thyroid cancer. Methods：Statistical analysis methods such as Analysis of Variance，Student’s t test and Mann-Whitney U test were used to analyze the changes of mean medical expenses，cost details，and average length of stay before and after the implementation of the quota payment of specific diseases. Results：After the implementation of the quota payment of specific diseases，the mean medical expenses of patients decreased by 3 566 Chinese Yuan，of which the drug cost decreased by 1 775 Chinese Yuan，with the most significant decrease（P < 0.05）；The average length of stay decreased by 2.8 days after the implementation of the quota payment of specific diseases，with significant difference showed by the results of Mann-Whitney U test. Conclusions：The implementation of the quota payment of specific diseases can effectively reduce the medical expenses and economical load of patients with thyroid cancer. It is necessary to establish a scientific and reasonable payment mechanism to enroll more diseases into the management of the quota payment of specific diseases.