Objective: To summarize the experiences and problems in economic management of county-level hospitals in Yulin area, provide decision foundation for the further reform of the county health service system in China. Methods: Using descriptive study to analyze the economic operation condition of the 5 pilot county-level hospitals. Results: The effect and issues of the reform both exist in financial input, pharmacy income, asset utilization and operation capabilities in pilot county-level hospitals. Conclusion: It is needed to deepen the operation mechanism and compensation mechanism of public hospitals, reform the “using drug to compensate the medicine” mechanism, strengthen the hospital asset management and optimize liability structure.