Abstract:Objective：To analyze the relevant data of medical expenses after the implementation of the settlement policy by disease score in acertain grade A tertiary hospital in Longyan City，understand the implementation status of payment by disease score，and analyze the influencing factors of deviation cases. Methods：The medical records and settlement data of discharged patients whose medical insurance type was Longyan Basic Medical Insurance from January to August 2021 in acertain grade A tertiary hospital in Longyan City were collected，totaling 47，177 cases. The settlement data were analyzed by descriptive statistics. The influencing factors were analyzed by logistic multiple linear regression. Results：Patients who were not transferred to departments，entered the clinical pathway，and had high-level operations were more likely to be in the normal range. Patients admitted to outpatient clinics，discharged without doctor’s orders，and admitted to ICU were more likely to be inclined to deviation cases.Doctor’s order transfer，the higher the proportion of drug consumption and the greater the number of diagnoses，the more prone to ultra-high cases.Elder patients are less prone to ultra-high cases. Conclusions：Whether transferred，age，admission route，length of hospital stay，surgery，level of surgery，discharge method，clinical pathway，ICU admission，drug ratio，consumption ratio，and number of diagnoses are the influencing factors of deviation cases.