Abstract:Objective：To study the changing trend and influencing factors of the total hospitalization expenses of the fractured with surgery in a certain grade A tertiary hospital during the “Thirteenth Five-Year Plan” Period.To explore the effect of the implementation of relevant policies on the reform of the medical and health system on the regulation of patients' hospitalization expenses. Methods：The basic information，clinical information，and hospitalization cost information of the fractured with surgery discharged from the hospital from January 1，2016 to December 31，2020 were extracted from the HIS system of a certain grade A tertiary hospital，conducted the descriptive analysis of the change trend of the total hospitalization expenses of patients and six key individual expenses（drug expenses，consumables expenses，inspection and inspection expenses，surgery and anesthesia expenses，diagnosis and treatment expenses，and nursing expenses），and the multiple linear regression was used to explore and analyze the impact factors influencing the total cost of hospitalization for patients. Results：From 2016 to 2020，after excluding the effect of price increase，the average hospitalization charge of the simple fractured with surgery was 36，735.49 yuan，and the total hospitalization charge showed a downward trend over time（P < 0.001）.Among the six single costs of focus，the drug costs showed a continuous downward trend，while the consumables costs，inspection and inspection costs，surgery and anesthesia costs，and nursing costs all showed an increasing trend over time（P < 0.001），while the changes in diagnosis and treatment costs without fixed trend. The results of multivariate regression analysis showed that the actual hospitalization days，blood transfusion treatment，and the implementation the policy of purchasing medicines with quantity increased the total hospitalization cost of the patient，while the low welfare type of medical insurance and the implementation of the cancellation of the drug addition policy could reduce the total hospitalization cost of the patient，while the implementation of taking consumables bonus policy and de-combining policy had not a significant impact. Conclusion：During the “Thirteenth Five-Year Plan” period，the total hospitalization expenses of patients with surgery after simple fractures in the military grade A tertiary hospital showed a downward trend，and the internal structure of expenses reflected the shift of drug expenses to labor expenses reflecting the technical value of medical personnel to a certain extent. The effect of a series of medical reform measures such as cancel the drug mark-up and consumables policy，and the policy of purchasing medicines with quantity on controlling the increase in the total hospitalization cost of patients should not only consider the type of disease，but also the implementation time，implementation strength，and supporting measures.