目的：分析甲状腺手术患者住院费用结构及影响因素，优化病组费用结构、减少不合理费用。方法：选取2021年1月1日-2024年12月31日南京市某公立医院（以下简称样本医院）KD19甲状腺大手术，主要诊断为甲状腺恶性肿瘤出院患者5，995例作为研究对象，运用结构变动度和灰色关联度法分析甲状腺癌手术患者住院费用结构及影响因素。结果：纳入研究的5，995例甲状腺癌手术患者住院费用呈增长趋势，增幅22.17%。在住院次均费用构成中，医疗服务费和材料费占据主导地位，平均占比达到74.56%。总体结构变动度为5.68%。药品费占比、化验费占比和医疗服务费占比呈负向变化，检查费占比和材料费占比呈正向变化。在关联度方面，化验费、医疗服务费和材料费呈现较高的关联性。结论：甲状腺癌手术患者经济压力并未减轻，应加强耗材使用管理，减少非必要的检查化验，继续提升医疗服务收入占比，改善住院费用结构。

Objective：To analyze the structure and influencing factors of hospitalization costs in patients undergoing thyroid surgery，optimize the cost structure of the disease group，and reduce unreasonable costs. Methods：From January 1，2021 to December 31，2024，5，995 patients discharged from KD19 major thyroid surgery in a certain public hospital in Nanjing（hereinafter referred to as the sample hospital）were selected as the research objects，and the structure variability and grey correlation method were used to analyze the hospitalization cost structure and influencing factors of thyroid cancer surgery patients. Results：The hospitalization costs of 5，995 thyroid cancer patients included in the study showed an increasing trend，with an increase of 22.17%. In the composition of the average cost of hospitalization，medical service income and material costs dominated，accounting for an average of 74.56%. The overall structural variability was 5.68%. The proportions of drug costs，laboratory fees and medical service costs showed negative changes，while the proportions of inspection fees and material costs showed positive changes. In terms of relevance，the cost of laboratory testing，medical services and materials showed a high correlation. Conclusion：The economic pressure of thyroid cancer surgery patients has not been alleviated，and the management of consumables should be strengthened，unnecessary examinations and tests should be reduced，the proportion of medical service income should be increased，and the inpatient cost structure should be improved.