Abstract:Objective：To analyze in-depth hospital records of abnormal expense cases under the three-year DRGs grouping of a psychiatric hospital in a certain grade A tertiary psychiatric hospital，and propose measures to solve the problems，so as to reduce the incidence of abnormal expense cases. Methods：Analyze the medical records of abnormal expense results from the hospital’s discharged medical records from May，2018 to April，2021 through the CHS-DRG1.1 grouping device，organize medical record experts and clinical experts to discuss the problem medical records，and adopt a standardized classification method，And normative means，to count the grouping results and coding conformance. Results：A total of 10，009 medical records had 343 cases of abnormal expense，of which 169 cases（49.27%）were mainly diagnosed as irregular；64 cases（18.66%）were filled out of complications or comorbidities；52 cases（15.16%）were defective in coding quality.；22 cases of coding mapping problems（6.41%）；the other 36 cases（10.50%）. Conclusion：The abnormal expense cases of DRGs cost show the problems of the first page data of psychiatric medical records，which are closely related to the standardization of doctors’ writing diagnosis and the professional skills of coding staff. Reducing abnormal expense cases is an important part of reasonable cost control，which can improve the completeness of filling in the medical insurance settlement list，standardize the diagnosis and treatment process，and improve the correctness of DRGs grouping，which is very important for hospital performance management.