Abstract:Objective：In order to explore the influencing factors of hospitalization costs of cerebral infarction patients in a certain grade A tertiary hospital under the background of medical insurance payment reform，in order to implement more refined management of cerebral infarction patients. Methods：The cases of cerebral ischemic disorders（cerebral infarction）from 2020 to 2023 were selected，and the influencing factors were analyzed by descriptive statistical analysis，Chi-square test and binary logistic regression model. Results：3，981 cases were included in the study，and the average cost of patients from 2020 to 2023 was 10，779.19 yuan，among which drug cost，examination cost and treatment cost were the main components of hospitalization cost，accounting for 18.53%，25.20% and 35.57%，respectively. The medical insurance in this group overspent every year，and the overspent cases were 644.85 yuan，369.43 yuan，1，545.51 yuan and 1，767.84 yuan，respectively. The main factors affecting the hospitalization cost are the gender of the patient，the way of admission，whether there are complications，whether the hospital is critical，the number of days in hospital and the department discharged. Conclusion：In order to adapt to the reform of medical insurance payment method，all medical institutions should strengthen the cost accounting of diseases，control medical expenses reasonably，reduce the number of hospitalization days to reduce the overspending of medical insurance，and promote the fine management of hospitals. At the same time，the medical insurance department should dynamically adjust the weight of the patient group and the grouping plan according to the local actual situation，so as to achieve a win-win situation among medical，insurance and patients.