Abstract: Objective To investigate the influence of coronavirus disease 2019 (COVID-19) on the hospitalization volume of patients with off-site medical insurance in a grade A tertiary hospital in a first-tier city. Methods A retrospective analysis was performed for the hospitalization volume of patients with off-site medical insurance in all departments of a grade A tertiary hospital in a first-tier city from February 1,2020 to April 30,2020 and during the same period of 2019. Results During the epidemic of COVID-19,the overall hospitalization volume of patients with off-site medical insurance decreased by 73.81%,and there were significant increases in average cost (36 019 yuan vs 46 186 yuan,P=0.00) and average length of stay (8.5 d vs 11.8 d,P=0.00) for each hospitalization.The top 10 departments with high hospitalization volume were basically the same as those during the same period last year,among which departments of internal medicine accounted for 30% and surgical departments accounted for 70%.These top 10 departments accounted for a large proportion of the patients with off-site medical insurance who were admitted to the hospital,with 66.48% in 2019 and 72.81% in 2020,among which department of medical oncology had the highest number of hospitalized patients.The epidemic had great impact on the overall hospitalization in the hospital,and there were 15 departments with a reduction of 80% or more in hospitalization volume,17 with a reduction of 60%-80%,and 5 with a reduction of 40%-60%.There was no significant change in the regions where the patients with off-site medical insurance came from epidemic. Conclusion COVID-19 has great impact on the hospitalization of patients with off-site medical insurance,and the overall hospitalization volume decreases by 74%.