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Objective:Based on the reform model of County Medical Community (CMC) in L District, China, this study analyzed the expenditure of medical insurance funds outside the CMC, explored the influencing factors of medical insurance funds flow in the reform and make suggestions for the reasonable control of medical insurance funds and deepening the medical community reform. Methods:The CMC in L District was used as the research object. Hospital grades and disease types were used as entry points, descriptive analysis and paired t test were used to study the out-of-community medical insurance funds expenditure indicators in L District from 2018 to 2020. Results:Medical treatment in medical institutions outside the CMC: although the number of municipal tertiary hospitals outside the community in L District is small, the amount of medical insurance settlement accounts for a large proportion. After the reform of total medical insurance package payment reform, the number of outpatient visits to medical institutions outside the community, tertiary and unclassified medical institutions all increased (P<0.01); the total per-visit outpatient cost, per-visit outpatient fund expenditure and per-visit outpatient out-of-pocket cost of municipal tertiary hospitals all increased (P<0.01). Types of diseases outside the CMC among the outpatient consultation for diseases in tertiary hospitals in L District outside the community, chronic diseases were stable in order and malignant tumors ranked first among the inpatient diseases. Psychiatric diseases dominated in the outpatient visits to unclassified hospitals in L District. Conclusion:The flow of medical insurance funds to tertiary hospitals in L District has increased year by year. The proportion of common diseases and multiple diseases outside the CMC and chronic diseases in tertiary hospitals outside the community is large and the loss of medical insurance funds outside the community has not improved significantly. In response to the above results, suggestions can be made for deepening the reform of medical community in L District, but more studies are to be conducted in the future to prove it.