Objective: The paper explores the correlation between nosocomial infection and its related risk factors and DIP settlement results, and to provide the reference for medical and health institutions to maximize the benefits of DIP settlement in the process of improving medical quality and safety. Methods: A total of 40572 medical insurance patients discharged from a county-level general hospital in 2021 were selected as the research objects, and SPSS 22.0 was used to analyze the influence of nosocomial infection and its related risk factors on the balance of DIP settlement. Results: Patient age, length of hospital stay, and invasive surgery or operation had a positive impact on the DIP settlement balance, while nosocomial infection, antimicrobial use and multidrug-resistant bacterial infection had a negative impact on the DIP settlement balance. Conclusion: Under the DIP medical insurance payment model, the hospital should improve the infection prevention and control management ability, reduce the DIP settlement balance, and increase economic benefits.