Objective: From the perspective of private specialized hospitals, this study analyzes their current operating status under the DRG payment, summarizes the challenges and problems faced by the operation and development, and proposes targeted operation and development strategies. Methods: A total of 6006 inpatient medical records from January 1, 2022 to August 31, 2022, and January 1, 2023 to August 31, 2023, were selected from a tertiary private specialized hospital in Qingdao City. This study uses the descriptive analysis method to conduct a basic analysis of the medical records of DRG from the four dimensions of medical service capacity, finance, medical quality and operational efficiency. It adopts the interrupted time series model to evaluate the impact of DRG payment on the operation of hospital. Results: Under the reform of the DRG payment,the hospital is faced with low weight of patient groups, making it difficult to reflect the value of diagnosis and treatment. The income has declined, and the development of discipline construction has been affected. The quality of medical services has declined, inducing unreasonable diagnosis and treatment behaviors. Departments lack awareness of the DRG payment policy, resulting in insufficient execution. Conclusions: Private specialized hospitals need to clarify the requirements of the DRG policy, and standardize the medical record management system through the weighting and scoring of precise disease groups. build a refined management system to promote the operation and development of the hospital. optimize the performance appraisal plan with medical quality as the core, improve the quality of DRG training, promote discipline construction, and make dynamic adjustments in combination with the actual development of the hospital, so as to improve the sustainable development ability of the hospital.