Basic information of medical insurance inpatients for urban and rural residents in 36 counties was obtained based on the provincial medical insurance information platform, and the flow of inpatients, the cost of inpatients and the distribution of medical insurance compensation fund were statistically described. From 2016 to 2019, the proportion of hospitalizations outside the county was 28.38%-30.79%; The average annual growth rates of total hospitalization cost, medical insurance compensation fund and average hospitalization cost were 6.76%, 11.34% and 4.79%, respectively. The proportion of total hospitalization expenses and medical insurance compensation funds outside the county increased year by year. The inpatient compensation ratio was 53.78% ~ 61.42%, and the inpatient compensation ratio outside the county increased year by year. From the perspective of the flow of inpatients of medical insurance for urban and rural residents, the effect of graded diagnosis and treatment has not yet been shown, and the trend of medical insurance compensation fund flowing outside the county area has not been effectively controlled. Measures should be taken to support the implementation of the hierarchical diagnosis and treatment system by strengthening the construction of the close-knit medical community and improving the service capacity at the grassroots level.