目的：分析某三甲传染病专科医院肝硬化患者DRG分组及住院费用影响因素，为制定及优化相关DRG组的住院费用标准提供参考依据。方法：收集某三甲传染病专科医院2021-2023年5 336例肝硬化患者数据，采用随机森林模型筛选影响住院费用的关键因素，并基于CHAID决策树算法构建病例组合模型及优化费用标准。结果：住院天数、并发症类型及参保类型是肝硬化患者住院费用的主要影响因素。基于CHAID决策树算法构建了11个肝硬化DRG分组，整体超额费用率为2.01%，费用控制效果良好。结论：本研究构建的肝硬化DRG分组模型科学合理，能够客观反映疾病复杂程度对医疗费用的影响，为医疗机构实施精准费用管控和优化临床路径管理提供了重要依据。

Objective：To analyze DRG grouping and cost determinants for liver cirrhosis patients in a certain grade A tertiary infectious disease hospital，providing evidence for optimizing DRG-based inpatient payment standards. Methods：Clinical data from 5，336 cirrhosis admissions at a certain grade A tertiary infectious disease hospital from 2021 to 2023 were analyzed using random forest to identify key cost drivers，followed by CHAID decision tree modeling to establish case-mix groups and cost benchmarks. Results：Length of stay，complication type，and insurance status emerged as primary determinants of hospitalization costs in cirrhotic patients. The CHAID decision tree algorithm-derived 11 DRG groups demonstrated excellent cost containment，with an overall excess cost rate of merely 2.01%. Conclusion：This study established a scientifically valid DRG grouping model for liver cirrhosis that accurately reflects disease complexity-related cost variations，providing a critical evidence-based framework for healthcare institutions to implement precise cost containment and optimize clinical pathway management.