Objective:To provide guidance for department operation and discipline development by analyzing the disease structure of the Department of Breast, Thyroid and Hernia Surgery in a Class-A tertiary hospital in Shandong Province.Methods:The inpatient medical record homepages of the Liaocheng People′s Hospital from January 1 to October 31, 2024, were collated, with a total of 113 857 medical records collected. Based on the International Classification of Diseases coding (ICD-10), and utilizing the Shanghai Lianzhong version Diagnosis-Related Group (DRG) grouper and the National Healthcare Security Diagnosis-Related Group (CHS-DRG) grouper version 1.1, combined with the performance evaluation indicators for national tertiary public hospitals (hereinafter referred to as the " National Evaluation" ), a four-quadrant analysis and analogy method were applied to study the disease structure, relative weight (RW), average profit/loss per case (average effective revenue per case), and the proportion of Level IV and minimally invasive surgeries in the Department of Breast, Thyroid, and Hernia Surgery.Results:Chemotherapy was the main disease type in the department, accounting for 43.25% of the total cases, but its RW was low, so it had no advantage in discipline development. Except for chemotherapy, thyroid surgery, abdominal external hernia surgery, and breast malignant tumor surgery were the main disease types, accounting for 39.73% of the total cases. Among them, thyroid surgery and breast malignant tumor surgery had advantages in discipline development in terms of the National Assessment system and medical insurance payment; in addition, grade IV surgeries were concentrated in thyroid surgery, and minimally invasive surgeries were concentrated in abdominal external hernia surgery.Conclusions:The characteristics of the disease structure of the Department of Breast, Thyroid and Hernia Surgery are initially grasped, the development direction of the department is clarified, the cost structure is optimized, and the disciplinary competitiveness is improved.