Objective: to evaluate the implementation effects of medical insurance scheme by global budget in one secondary A hospital. Methods: to collect the qualitative and quantitative data by interview and field investigation and to analyze the data by descriptive and inferential statistics. Results: medical workload increased, technical efficiency improved, but the cost control effect was not good, the total cost increased significantly, the average cost increased slightly and medical quality decreased. Conclusion: Local medical insurance authority should formulate the total amount and index scientifically and rationally and the hospital should further improve the implementation and evaluation scheme of global budget, improve the supervision mechanism and perfect the medical quality.