Abstract:Objective This paper analyzes the reasons of unreasonable increase of medical expenses in community health service center by using fishbone diagram model, and puts forward countermeasures and suggestions. Methods Using the fishbone diagram theory model, this paper analyzes the reasons for the unreasonable growth of medical expenses from six aspects: cultural background, external environment, institutional system, management ability and service providers and needs. Results The unreasonable increase of medical insurance cost is not a single factor problem. In terms of cultural background, it is mainly the cultural idea that the administrators believe that the medical cost is the income of the hospital, the more the income formed in a long time, the better; the external environment is mainly the tense relationship between doctors and patients, in order to avoid disputes caused by misdiagnosis, which leads to excessive diagnosis and treatment; in terms of institutional system, it is mainly the medical treatment The insurance expense is approved in the way of "historical model". Medical institutions at all levels hope to exceed a part every year to pave the way for the next year's budget. The problem of service provider is mainly the personal interest seeking behavior of doctors with prescription right. The service object is mainly because the medical insurance has no restriction on the service object.Conclusion The unreasonable increase of medical insurance cost is a multi factor problem. To control the unreasonable increase of medical insurance cost, we need to perfect the top-level design, solve the system problems, improve the treatment of doctors, and put an end to the profit seeking behavior of doctors, change the medical behavior of patients, and establish a good and effective medical order. At the same time, we need to learn from and implement the model of foreign family doctors to manage medical insurance cost, By combining the right to sign a contract with the right to use the fund, the family doctors manage the disease and control the cost through measures such as forcing the first diagnosis in the community, two-way referral between general practice and specialty.