Abstract:Objective：To compare the hospitalization cost structure，cost differences and profit and loss status of patients undergoing endoscopic cholecystectomy（NJ-DRG HC25 disease group）in a certain tertiary geriatric hospital before and after the implementation of the diagnosis-related grouping（DRG）payment method of medical insurance in Nanjing. Methods：Descriptive analysis of hospitalization costs and composition of patients. The expense of hospitalization and its composition before and after DRG reform were compared by nonparametric rank sum test comparison method. Spearman correlation was used to analysis the correlation between profit and loss levels and age，gender，the length of hospitalization. Results：The top three of the averagehospitalization expenses in the HC25 groupwere respectively consumable expenses，drug expenses and treatment expenses. There is a significant difference in the total hospitalization expenses of the HC25 group before and after the implementation of DRG. Growth trend in 2022 compared to 2021. DRG profit and loss status is related to age and length of hospitalization. Conclusion：Focusedsupervisionshould be adopted on consumable expenses，drug expenses to reduce the total cost of hospitalization and control cost growth. DRG fee control is a long-term process.To achieve desirable results，DRG reform should be collaborativelypromoted with clinical pathway，performance assessment，drug and consumable administration，central purchasing. DRG reform needs internal optimization and dynamic adjustment continuously.