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PHP Version 5.6.40

System Windows NT iZ4r4b31413jd2Z 10.0 build 14393 (Windows Server 2016) AMD64
Build Date Jan 9 2019 15:05:36
Compiler MSVC11 (Visual C++ 2012)
Architecture x64
Configure Command cscript /nologo configure.js "--enable-snapshot-build" "--enable-debug-pack" "--disable-zts" "--disable-isapi" "--disable-nsapi" "--without-mssql" "--without-pdo-mssql" "--without-pi3web" "--with-pdo-oci=c:\php-sdk\oracle\x64\instantclient_12_1\sdk,shared" "--with-oci8-12c=c:\php-sdk\oracle\x64\instantclient_12_1\sdk,shared" "--with-enchant=shared" "--enable-object-out-dir=../obj/" "--enable-com-dotnet=shared" "--with-mcrypt=static" "--without-analyzer" "--with-pgo"
Server API CGI/FastCGI
Virtual Directory Support disabled
Configuration File (php.ini) Path C:\Windows
Loaded Configuration File D:\PHPWEB\php\php.ini
Scan this dir for additional .ini files (none)
Additional .ini files parsed (none)
PHP API 20131106
PHP Extension 20131226
Zend Extension 220131226
Zend Extension Build API220131226,NTS,VC11
PHP Extension Build API20131226,NTS,VC11
Debug Build no
Thread Safety disabled
Zend Signal Handling disabled
Zend Memory Manager enabled
Zend Multibyte Support provided by mbstring
IPv6 Support enabled
DTrace Support disabled
Registered PHP Streamsphp, file, glob, data, http, ftp, zip, compress.zlib, compress.bzip2, https, ftps, phar
Registered Stream Socket Transportstcp, udp, ssl, sslv3, tls, tlsv1.0, tlsv1.1, tlsv1.2
Registered Stream Filtersconvert.iconv.*, mcrypt.*, mdecrypt.*, string.rot13, string.toupper, string.tolower, string.strip_tags, convert.*, consumed, dechunk, zlib.*, bzip2.*
Zend logo This program makes use of the Zend Scripting Language Engine:
Zend Engine v2.6.0, Copyright (c) 1998-2016 Zend Technologies

Configuration

bcmath

BCMath support enabled
DirectiveLocal ValueMaster Value
bcmath.scale00

bz2

BZip2 Support Enabled
Stream Wrapper support compress.bzip2://
Stream Filter support bzip2.decompress, bzip2.compress
BZip2 Version 1.0.6, 6-Sept-2010

calendar

Calendar support enabled

cgi-fcgi

DirectiveLocal ValueMaster Value
cgi.check_shebang_line11
cgi.discard_path00
cgi.fix_pathinfo11
cgi.force_redirect00
cgi.nph00
cgi.redirect_status_envno valueno value
cgi.rfc2616_headers00
fastcgi.impersonate11
fastcgi.logging11

Core

PHP Version 5.6.40
DirectiveLocal ValueMaster Value
allow_url_fopenOnOn
allow_url_includeOffOff
always_populate_raw_post_data00
arg_separator.input&&
arg_separator.output&&
asp_tagsOffOff
auto_append_fileno valueno value
auto_globals_jitOnOn
auto_prepend_fileno valueno value
browscapno valueno value
default_charsetUTF-8UTF-8
default_mimetypetext/htmltext/html
disable_classesno valueno value
disable_functionsexec,system,passthru,popen,pclose,shell_exec,proc_open,dl,chmodexec,system,passthru,popen,pclose,shell_exec,proc_open,dl,chmod
display_errorsOffOff
display_startup_errorsOffOff
doc_rootno valueno value
docref_extno valueno value
docref_rootno valueno value
enable_dlOffOff
enable_post_data_readingOnOn
error_append_stringno valueno value
error_logsyslogsyslog
error_prepend_stringno valueno value
error_reporting2252722527
exit_on_timeoutOffOff
expose_phpOnOn
extension_dir./ext./ext
file_uploadsOnOn
highlight.comment#FF8000#FF8000
highlight.default#0000BB#0000BB
highlight.html#000000#000000
highlight.keyword#007700#007700
highlight.string#DD0000#DD0000
html_errorsOnOn
ignore_repeated_errorsOffOff
ignore_repeated_sourceOffOff
ignore_user_abortOffOff
implicit_flushOffOff
include_path.;C:\php\pear;D:\wwwroot\yyjg.net\wwwroot\core/Extend/Vendor/.;C:\php\pear
input_encodingno valueno value
internal_encodingno valueno value
log_errorsOnOn
log_errors_max_len10241024
mail.add_x_headerOnOn
mail.force_extra_parametersno valueno value
mail.logno valueno value
max_execution_time180180
max_file_uploads200200
max_input_nesting_level6464
max_input_time6060
max_input_vars10001000
memory_limit128M128M
open_basedirno valueno value
output_buffering40964096
output_encodingno valueno value
output_handlerno valueno value
post_max_size200M200M
precision1414
realpath_cache_size16K16K
realpath_cache_ttl120120
register_argc_argvOffOff
report_memleaksOnOn
report_zend_debugOnOn
request_orderCGPCGP
sendmail_fromno valueno value
sendmail_pathno valueno value
serialize_precision1717
short_open_tagOnOn
SMTPlocalhostlocalhost
smtp_port2525
sql.safe_modeOffOff
sys_temp_dirno valueno value
track_errorsOffOff
unserialize_callback_funcno valueno value
upload_max_filesize200M200M
upload_tmp_dirD:\PHPWEB\php\temp\D:\PHPWEB\php\temp\
user_dirno valueno value
user_ini.cache_ttl300300
user_ini.filename.user.ini.user.ini
variables_orderGPCSGPCS
windows.show_crt_warningOffOff
xmlrpc_error_number00
xmlrpc_errorsOffOff
zend.detect_unicodeOnOn
zend.enable_gcOnOn
zend.multibyteOffOff
zend.script_encodingno valueno value

ctype

ctype functions enabled

curl

cURL support enabled
cURL Information 7.59.0
Age 4
Features
AsynchDNS Yes
CharConv No
Debug No
GSS-Negotiate No
IDN Yes
IPv6 Yes
krb4 No
Largefile Yes
libz Yes
NTLM Yes
NTLMWB No
SPNEGO Yes
SSL Yes
SSPI Yes
TLS-SRP No
Protocols dict, file, ftp, ftps, gopher, http, https, imap, imaps, ldap, pop3, pop3s, rtsp, scp, sftp, smb, smbs, smtp, smtps, telnet, tftp
Host x86_64-pc-win32
SSL Version OpenSSL/1.0.2q
ZLib Version 1.2.7.3
libSSH Version libssh2/1.8.0

date

date/time support enabled
"Olson" Timezone Database Version 2016.10
Timezone Database internal
Default timezone PRC
DirectiveLocal ValueMaster Value
date.default_latitude31.766731.7667
date.default_longitude35.233335.2333
date.sunrise_zenith90.58333390.583333
date.sunset_zenith90.58333390.583333
date.timezonePRCPRC

dom

DOM/XML enabled
DOM/XML API Version 20031129
libxml Version 2.9.4
HTML Support enabled
XPath Support enabled
XPointer Support enabled
Schema Support enabled
RelaxNG Support enabled

ereg

Regex Library Bundled library enabled

exif

EXIF Support enabled
EXIF Version 1.4 $Id: cad29b729548e4206f0697710cc9e177f26fdff3 $
Supported EXIF Version 0220
Supported filetypes JPEG,TIFF
DirectiveLocal ValueMaster Value
exif.decode_jis_intelJISJIS
exif.decode_jis_motorolaJISJIS
exif.decode_unicode_intelUCS-2LEUCS-2LE
exif.decode_unicode_motorolaUCS-2BEUCS-2BE
exif.encode_jisno valueno value
exif.encode_unicodeISO-8859-15ISO-8859-15

filter

Input Validation and Filtering enabled
Revision $Id: 5b79667bd9a68977a9b4f7505223a8e216e04908 $
DirectiveLocal ValueMaster Value
filter.defaultunsafe_rawunsafe_raw
filter.default_flagsno valueno value

ftp

FTP support enabled

gd

GD Support enabled
GD Version bundled (2.1.0 compatible)
FreeType Support enabled
FreeType Linkage with freetype
FreeType Version 2.7.0
GIF Read Support enabled
GIF Create Support enabled
JPEG Support enabled
libJPEG Version 9 compatible
PNG Support enabled
libPNG Version 1.5.26
WBMP Support enabled
XPM Support enabled
libXpm Version 30512
XBM Support enabled
WebP Support enabled
DirectiveLocal ValueMaster Value
gd.jpeg_ignore_warning00

hash

hash support enabled
Hashing Engines md2 md4 md5 sha1 sha224 sha256 sha384 sha512 ripemd128 ripemd160 ripemd256 ripemd320 whirlpool tiger128,3 tiger160,3 tiger192,3 tiger128,4 tiger160,4 tiger192,4 snefru snefru256 gost gost-crypto adler32 crc32 crc32b fnv132 fnv1a32 fnv164 fnv1a64 joaat haval128,3 haval160,3 haval192,3 haval224,3 haval256,3 haval128,4 haval160,4 haval192,4 haval224,4 haval256,4 haval128,5 haval160,5 haval192,5 haval224,5 haval256,5

iconv

iconv support enabled
iconv implementation "libiconv"
iconv library version 1.14
DirectiveLocal ValueMaster Value
iconv.input_encodingno valueno value
iconv.internal_encodingno valueno value
iconv.output_encodingno valueno value

json

json support enabled
json version 1.2.1

libxml

libXML support active
libXML Compiled Version 2.9.4
libXML Loaded Version 20904
libXML streams enabled

mbstring

Multibyte Support enabled
Multibyte string engine libmbfl
HTTP input encoding translation disabled
libmbfl version 1.3.2
mbstring extension makes use of "streamable kanji code filter and converter", which is distributed under the GNU Lesser General Public License version 2.1.
Multibyte (japanese) regex support enabled
Multibyte regex (oniguruma) version 5.9.5
DirectiveLocal ValueMaster Value
mbstring.detect_orderno valueno value
mbstring.encoding_translationOffOff
mbstring.func_overload00
mbstring.http_inputno valueno value
mbstring.http_outputno valueno value
mbstring.http_output_conv_mimetypes^(text/|application/xhtml\+xml)^(text/|application/xhtml\+xml)
mbstring.internal_encodingno valueno value
mbstring.languageneutralneutral
mbstring.strict_detectionOffOff
mbstring.substitute_characterno valueno value

mcrypt

mcrypt supportenabled
mcrypt_filter supportenabled
Version 2.5.8
Api No 20021217
Supported ciphers cast-128 gost rijndael-128 twofish cast-256 loki97 rijndael-192 saferplus wake blowfish-compat des rijndael-256 serpent xtea blowfish enigma rc2 tripledes arcfour
Supported modes cbc cfb ctr ecb ncfb nofb ofb stream
DirectiveLocal ValueMaster Value
mcrypt.algorithms_dirno valueno value
mcrypt.modes_dirno valueno value

mhash

MHASH support Enabled
MHASH API Version Emulated Support

mysql

MySQL Supportenabled
Active Persistent Links 0
Active Links 1
Client API version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $
DirectiveLocal ValueMaster Value
mysql.allow_local_infileOnOn
mysql.allow_persistentOnOn
mysql.connect_timeout6060
mysql.default_hostno valueno value
mysql.default_passwordno valueno value
mysql.default_portno valueno value
mysql.default_socketno valueno value
mysql.default_userno valueno value
mysql.max_linksUnlimitedUnlimited
mysql.max_persistentUnlimitedUnlimited
mysql.trace_modeOffOff

mysqli

MysqlI Supportenabled
Client API library version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $
Active Persistent Links 0
Inactive Persistent Links 0
Active Links 0
DirectiveLocal ValueMaster Value
mysqli.allow_local_infileOnOn
mysqli.allow_persistentOnOn
mysqli.default_hostno valueno value
mysqli.default_port33063306
mysqli.default_pwno valueno value
mysqli.default_socketno valueno value
mysqli.default_userno valueno value
mysqli.max_linksUnlimitedUnlimited
mysqli.max_persistentUnlimitedUnlimited
mysqli.reconnectOffOff
mysqli.rollback_on_cached_plinkOffOff

mysqlnd

mysqlndenabled
Version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $
Compression supported
core SSL supported
extended SSL not supported
Command buffer size 4096
Read buffer size 32768
Read timeout 31536000
Collecting statistics Yes
Collecting memory statistics No
Tracing n/a
Loaded plugins mysqlnd,debug_trace,auth_plugin_mysql_native_password,auth_plugin_mysql_clear_password
API Extensions mysql,mysqli,pdo_mysql
mysqlnd statistics
bytes_sent 136574
bytes_received 2832733
packets_sent 2632
packets_received 21126
protocol_overhead_in 84504
protocol_overhead_out 10528
bytes_received_ok_packet 0
bytes_received_eof_packet 0
bytes_received_rset_header_packet 10323
bytes_received_rset_field_meta_packet 0
bytes_received_rset_row_packet 7503
bytes_received_prepare_response_packet 1044563
bytes_received_change_user_packet 1761177
packets_sent_command 1268
packets_received_ok 0
packets_received_eof 0
packets_received_rset_header 1147
packets_received_rset_field_meta 0
packets_received_rset_row 1197
packets_received_prepare_response 15133
packets_received_change_user 3553
result_set_queries 1123
non_result_set_queries 70
no_index_used 666
bad_index_used 0
slow_queries 0
buffered_sets 1123
unbuffered_sets 0
ps_buffered_sets 0
ps_unbuffered_sets 0
flushed_normal_sets 0
flushed_ps_sets 0
ps_prepared_never_executed 0
ps_prepared_once_executed 0
rows_fetched_from_server_normal 2430
rows_fetched_from_server_ps 0
rows_buffered_from_client_normal 2430
rows_buffered_from_client_ps 0
rows_fetched_from_client_normal_buffered 2430
rows_fetched_from_client_normal_unbuffered 0
rows_fetched_from_client_ps_buffered 0
rows_fetched_from_client_ps_unbuffered 0
rows_fetched_from_client_ps_cursor 0
rows_affected_normal 22
rows_affected_ps 0
rows_skipped_normal 2430
rows_skipped_ps 0
copy_on_write_saved 5442
copy_on_write_performed 41019
command_buffer_too_small 0
connect_success 24
connect_failure 0
connection_reused 0
reconnect 0
pconnect_success 0
active_connections 18446744073709551594
active_persistent_connections 0
explicit_close 23
implicit_close 0
disconnect_close 0
in_middle_of_command_close 0
explicit_free_result 1122
implicit_free_result 0
explicit_stmt_close 0
implicit_stmt_close 0
mem_emalloc_count 0
mem_emalloc_amount 0
mem_ecalloc_count 0
mem_ecalloc_amount 0
mem_erealloc_count 0
mem_erealloc_amount 0
mem_efree_count 0
mem_efree_amount 0
mem_malloc_count 0
mem_malloc_amount 0
mem_calloc_count 0
mem_calloc_amount 0
mem_realloc_count 0
mem_realloc_amount 0
mem_free_count 0
mem_free_amount 0
mem_estrndup_count 0
mem_strndup_count 0
mem_estndup_count 0
mem_strdup_count 0
proto_text_fetched_null 0
proto_text_fetched_bit 0
proto_text_fetched_tinyint 4159
proto_text_fetched_short 14045
proto_text_fetched_int24 1628
proto_text_fetched_int 1943
proto_text_fetched_bigint 10
proto_text_fetched_decimal 0
proto_text_fetched_float 0
proto_text_fetched_double 0
proto_text_fetched_date 0
proto_text_fetched_year 0
proto_text_fetched_time 0
proto_text_fetched_datetime 0
proto_text_fetched_timestamp 0
proto_text_fetched_string 21483
proto_text_fetched_blob 0
proto_text_fetched_enum 111
proto_text_fetched_set 0
proto_text_fetched_geometry 0
proto_text_fetched_other 0
proto_binary_fetched_null 0
proto_binary_fetched_bit 0
proto_binary_fetched_tinyint 0
proto_binary_fetched_short 0
proto_binary_fetched_int24 0
proto_binary_fetched_int 0
proto_binary_fetched_bigint 0
proto_binary_fetched_decimal 0
proto_binary_fetched_float 0
proto_binary_fetched_double 0
proto_binary_fetched_date 0
proto_binary_fetched_year 0
proto_binary_fetched_time 0
proto_binary_fetched_datetime 0
proto_binary_fetched_timestamp 0
proto_binary_fetched_string 0
proto_binary_fetched_json 0
proto_binary_fetched_blob 0
proto_binary_fetched_enum 0
proto_binary_fetched_set 0
proto_binary_fetched_geometry 0
proto_binary_fetched_other 0
init_command_executed_count 0
init_command_failed_count 0
com_quit 23
com_init_db 24
com_query 1197
com_field_list 0
com_create_db 0
com_drop_db 0
com_refresh 0
com_shutdown 0
com_statistics 0
com_process_info 0
com_connect 0
com_process_kill 0
com_debug 0
com_ping 0
com_time 0
com_delayed_insert 0
com_change_user 0
com_binlog_dump 0
com_table_dump 0
com_connect_out 0
com_register_slave 0
com_stmt_prepare 0
com_stmt_execute 0
com_stmt_send_long_data 0
com_stmt_close 0
com_stmt_reset 0
com_stmt_set_option 24
com_stmt_fetch 0
com_deamon 0
bytes_received_real_data_normal 1700279
bytes_received_real_data_ps 0

odbc

ODBC Supportenabled
Active Persistent Links 0
Active Links 0
ODBC library Win32
DirectiveLocal ValueMaster Value
odbc.allow_persistentOnOn
odbc.check_persistentOnOn
odbc.default_cursortypeStatic cursorStatic cursor
odbc.default_dbno valueno value
odbc.default_pwno valueno value
odbc.default_userno valueno value
odbc.defaultbinmodereturn as isreturn as is
odbc.defaultlrlreturn up to 4096 bytesreturn up to 4096 bytes
odbc.max_linksUnlimitedUnlimited
odbc.max_persistentUnlimitedUnlimited

openssl

OpenSSL support enabled
OpenSSL Library Version OpenSSL 1.0.2q 20 Nov 2018
OpenSSL Header Version OpenSSL 1.0.2q 20 Nov 2018
Openssl default config c:/usr/local/ssl/openssl.cnf
DirectiveLocal ValueMaster Value
openssl.cafileno valueno value
openssl.capathno valueno value

pcre

PCRE (Perl Compatible Regular Expressions) Support enabled
PCRE Library Version 8.38 2015-11-23
DirectiveLocal ValueMaster Value
pcre.backtrack_limit10000001000000
pcre.recursion_limit100000100000

PDO

PDO supportenabled
PDO drivers mysql, odbc, pgsql, sqlite

pdo_mysql

PDO Driver for MySQLenabled
Client API version mysqlnd 5.0.11-dev - 20120503 - $Id: 76b08b24596e12d4553bd41fc93cccd5bac2fe7a $

PDO_ODBC

PDO Driver for ODBC (Win32)enabled
ODBC Connection Pooling Enabled, strict matching

pdo_pgsql

PDO Driver for PostgreSQLenabled
PostgreSQL(libpq) Version 9.6.2
Module version 1.0.2
Revision $Id: 0e858dd2051ca8c2fd3c781909a0670ab5fecd36 $

pdo_sqlite

PDO Driver for SQLite 3.xenabled
SQLite Library 3.8.10.2

pgsql

PostgreSQL Supportenabled
PostgreSQL(libpq) Version 9.6.2
PostgreSQL(libpq) PostgreSQL 9.6.2 (win32)
Multibyte character support enabled
SSL support enabled
Active Persistent Links 0
Active Links 0
DirectiveLocal ValueMaster Value
pgsql.allow_persistentOnOn
pgsql.auto_reset_persistentOffOff
pgsql.ignore_noticeOffOff
pgsql.log_noticeOffOff
pgsql.max_linksUnlimitedUnlimited
pgsql.max_persistentUnlimitedUnlimited

Phar

Phar: PHP Archive supportenabled
Phar EXT version 2.0.2
Phar API version 1.1.1
SVN revision $Id: 6e5cec2462a6ded53d4379ea9a69487a60d5c43c $
Phar-based phar archives enabled
Tar-based phar archives enabled
ZIP-based phar archives enabled
gzip compression enabled
bzip2 compression enabled
OpenSSL support enabled
Phar based on pear/PHP_Archive, original concept by Davey Shafik.
Phar fully realized by Gregory Beaver and Marcus Boerger.
Portions of tar implementation Copyright (c) 2003-2009 Tim Kientzle.
DirectiveLocal ValueMaster Value
phar.cache_listno valueno value
phar.readonlyOnOn
phar.require_hashOnOn

Reflection

Reflectionenabled
Version $Id: 5f15287237d5f78d75b19c26915aa7bd83dee8b8 $

session

Session Support enabled
Registered save handlers files user
Registered serializer handlers php_serialize php php_binary wddx
DirectiveLocal ValueMaster Value
session.auto_startOffOff
session.cache_expire180180
session.cache_limiternocachenocache
session.cookie_domainno valueno value
session.cookie_httponlyOffOff
session.cookie_lifetime00
session.cookie_path//
session.cookie_secureOffOff
session.entropy_fileno valueno value
session.entropy_length00
session.gc_divisor10001000
session.gc_maxlifetime14401440
session.gc_probability11
session.hash_bits_per_character55
session.hash_function00
session.namePHPSESSIDPHPSESSID
session.referer_checkno valueno value
session.save_handlerfilesfiles
session.save_pathD:\PHPWEB\php\temp\D:\PHPWEB\php\temp\
session.serialize_handlerphpphp
session.upload_progress.cleanupOnOn
session.upload_progress.enabledOnOn
session.upload_progress.freq1%1%
session.upload_progress.min_freq11
session.upload_progress.namePHP_SESSION_UPLOAD_PROGRESSPHP_SESSION_UPLOAD_PROGRESS
session.upload_progress.prefixupload_progress_upload_progress_
session.use_cookiesOnOn
session.use_only_cookiesOnOn
session.use_strict_modeOffOff
session.use_trans_sid00

SimpleXML

Simplexml supportenabled
Revision $Id: d7077fc935154236afb4fe70814ba358efdbdca4 $
Schema support enabled

SPL

SPL supportenabled
Interfaces Countable, OuterIterator, RecursiveIterator, SeekableIterator, SplObserver, SplSubject
Classes AppendIterator, ArrayIterator, ArrayObject, BadFunctionCallException, BadMethodCallException, CachingIterator, CallbackFilterIterator, DirectoryIterator, DomainException, EmptyIterator, FilesystemIterator, FilterIterator, GlobIterator, InfiniteIterator, InvalidArgumentException, IteratorIterator, LengthException, LimitIterator, LogicException, MultipleIterator, NoRewindIterator, OutOfBoundsException, OutOfRangeException, OverflowException, ParentIterator, RangeException, RecursiveArrayIterator, RecursiveCachingIterator, RecursiveCallbackFilterIterator, RecursiveDirectoryIterator, RecursiveFilterIterator, RecursiveIteratorIterator, RecursiveRegexIterator, RecursiveTreeIterator, RegexIterator, RuntimeException, SplDoublyLinkedList, SplFileInfo, SplFileObject, SplFixedArray, SplHeap, SplMinHeap, SplMaxHeap, SplObjectStorage, SplPriorityQueue, SplQueue, SplStack, SplTempFileObject, UnderflowException, UnexpectedValueException

sqlite3

SQLite3 supportenabled
SQLite3 module version 0.7-dev
SQLite Library 3.8.10.2
DirectiveLocal ValueMaster Value
sqlite3.extension_dirno valueno value

standard

Dynamic Library Support enabled
Internal Sendmail Support for Windows enabled
DirectiveLocal ValueMaster Value
assert.active11
assert.bail00
assert.callbackno valueno value
assert.quiet_eval00
assert.warning11
auto_detect_line_endings00
default_socket_timeout6060
fromno valueno value
url_rewriter.tagsa=href,area=href,frame=src,input=src,form=fakeentrya=href,area=href,frame=src,input=src,form=fakeentry
user_agentno valueno value

tokenizer

Tokenizer Support enabled

wddx

WDDX Supportenabled
WDDX Session Serializer enabled

xml

XML Support active
XML Namespace Support active
libxml2 Version 2.9.4

xmlreader

XMLReader enabled

xmlwriter

XMLWriter enabled

zip

Zip enabled
Zip version 1.12.5
Libzip version 0.11.2

zlib

ZLib Supportenabled
Stream Wrapper compress.zlib://
Stream Filter zlib.inflate, zlib.deflate
Compiled Version 1.2.7.3
Linked Version 1.2.7.3
DirectiveLocal ValueMaster Value
zlib.output_compressionOffOff
zlib.output_compression_level-1-1
zlib.output_handlerno valueno value

Additional Modules

Module Name

Environment

VariableValue
_FCGI_X_PIPE_ \\.\pipe\IISFCGI-3095b68f-3f89-47e3-947b-99e55569fd61
PHP_FCGI_MAX_REQUESTS 10000
ALLUSERSPROFILE C:\ProgramData
APPDATA C:\Windows\system32\config\systemprofile\AppData\Roaming
APP_POOL_CONFIG C:\inetpub\temp\apppools\wwwroot\wwwroot.config
APP_POOL_ID wwwroot
CommonProgramFiles C:\Program Files\Common Files
CommonProgramFiles(x86) C:\Program Files (x86)\Common Files
CommonProgramW6432 C:\Program Files\Common Files
COMPUTERNAME iZ4r4b31413jd2Z
ComSpec C:\Windows\system32\cmd.exe
LOCALAPPDATA C:\Windows\system32\config\systemprofile\AppData\Local
NUMBER_OF_PROCESSORS 2
OS Windows_NT
Path C:\Windows\system32;C:\Windows;C:\Windows\System32\Wbem;C:\Windows\System32\WindowsPowerShell\v1.0\;D:\Program Files\Microsoft SQL Server\110\DTS\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\ManagementStudio\;C:\Program Files (x86)\Microsoft Visual Studio 10.0\Common7\IDE\PrivateAssemblies\;D:\Program Files (x86)\Microsoft SQL Server\110\DTS\Binn\;C:\sslctlw;C:\Windows\system32\config\systemprofile\AppData\Local\Microsoft\WindowsApps
PATHEXT .COM;.EXE;.BAT;.CMD;.VBS;.VBE;.JS;.JSE;.WSF;.WSH;.MSC
PROCESSOR_ARCHITECTURE AMD64
PROCESSOR_IDENTIFIER Intel64 Family 6 Model 85 Stepping 4, GenuineIntel
PROCESSOR_LEVEL 6
PROCESSOR_REVISION 5504
ProgramData C:\ProgramData
ProgramFiles C:\Program Files
ProgramFiles(x86) C:\Program Files (x86)
ProgramW6432 C:\Program Files
PSModulePath C:\Program Files\WindowsPowerShell\Modules;C:\Windows\system32\WindowsPowerShell\v1.0\Modules;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\PowerShell\Modules\
PUBLIC C:\Users\Public
SystemDrive C:
SystemRoot C:\Windows
TEMP C:\Windows\TEMP
TMP C:\Windows\TEMP
USERDOMAIN WORKGROUP
USERNAME iZ4r4b31413jd2Z$
USERPROFILE C:\Windows\system32\config\systemprofile
windir C:\Windows

PHP Variables

VariableValue
_REQUEST["aid"]13693
_REQUEST["_URL_"]
Array
(
    [0] => index
    [1] => view
    [2] => aid
    [3] => 13693
)
_GET["aid"]13693
_GET["_URL_"]
Array
(
    [0] => index
    [1] => view
    [2] => aid
    [3] => 13693
)
_SERVER["_FCGI_X_PIPE_"]\\.\pipe\IISFCGI-3095b68f-3f89-47e3-947b-99e55569fd61
_SERVER["PHP_FCGI_MAX_REQUESTS"]10000
_SERVER["ALLUSERSPROFILE"]C:\ProgramData
_SERVER["APPDATA"]C:\Windows\system32\config\systemprofile\AppData\Roaming
_SERVER["APP_POOL_CONFIG"]C:\inetpub\temp\apppools\wwwroot\wwwroot.config
_SERVER["APP_POOL_ID"]wwwroot
_SERVER["CommonProgramFiles"]C:\Program Files\Common Files
_SERVER["CommonProgramFiles(x86)"]C:\Program Files (x86)\Common Files
_SERVER["CommonProgramW6432"]C:\Program Files\Common Files
_SERVER["COMPUTERNAME"]iZ4r4b31413jd2Z
_SERVER["ComSpec"]C:\Windows\system32\cmd.exe
_SERVER["LOCALAPPDATA"]C:\Windows\system32\config\systemprofile\AppData\Local
_SERVER["NUMBER_OF_PROCESSORS"]2
_SERVER["OS"]Windows_NT
_SERVER["Path"]C:\Windows\system32;C:\Windows;C:\Windows\System32\Wbem;C:\Windows\System32\WindowsPowerShell\v1.0\;D:\Program Files\Microsoft SQL Server\110\DTS\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files\Microsoft SQL Server\110\Tools\Binn\;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\Binn\ManagementStudio\;C:\Program Files (x86)\Microsoft Visual Studio 10.0\Common7\IDE\PrivateAssemblies\;D:\Program Files (x86)\Microsoft SQL Server\110\DTS\Binn\;C:\sslctlw;C:\Windows\system32\config\systemprofile\AppData\Local\Microsoft\WindowsApps
_SERVER["PATHEXT"].COM;.EXE;.BAT;.CMD;.VBS;.VBE;.JS;.JSE;.WSF;.WSH;.MSC
_SERVER["PROCESSOR_ARCHITECTURE"]AMD64
_SERVER["PROCESSOR_IDENTIFIER"]Intel64 Family 6 Model 85 Stepping 4, GenuineIntel
_SERVER["PROCESSOR_LEVEL"]6
_SERVER["PROCESSOR_REVISION"]5504
_SERVER["ProgramData"]C:\ProgramData
_SERVER["ProgramFiles"]C:\Program Files
_SERVER["ProgramFiles(x86)"]C:\Program Files (x86)
_SERVER["ProgramW6432"]C:\Program Files
_SERVER["PSModulePath"]C:\Program Files\WindowsPowerShell\Modules;C:\Windows\system32\WindowsPowerShell\v1.0\Modules;D:\Program Files (x86)\Microsoft SQL Server\110\Tools\PowerShell\Modules\
_SERVER["PUBLIC"]C:\Users\Public
_SERVER["SystemDrive"]C:
_SERVER["SystemRoot"]C:\Windows
_SERVER["TEMP"]C:\Windows\TEMP
_SERVER["TMP"]C:\Windows\TEMP
_SERVER["USERDOMAIN"]WORKGROUP
_SERVER["USERNAME"]iZ4r4b31413jd2Z$
_SERVER["USERPROFILE"]C:\Windows\system32\config\systemprofile
_SERVER["windir"]C:\Windows
_SERVER["ORIG_PATH_INFO"]/admin.php/index/view/aid/13693.html
_SERVER["URL"]/admin.php
_SERVER["SERVER_SOFTWARE"]Microsoft-IIS/10.0
_SERVER["SERVER_PROTOCOL"]HTTP/1.1
_SERVER["SERVER_PORT_SECURE"]1
_SERVER["SERVER_PORT"]443
_SERVER["SERVER_NAME"]www.yyjg.net
_SERVER["SCRIPT_NAME"]/admin.php
_SERVER["SCRIPT_FILENAME"]D:\wwwroot\yyjg.net\wwwroot\admin.php
_SERVER["REQUEST_URI"]/admin.php/index/view/aid/13693.html
_SERVER["REQUEST_METHOD"]GET
_SERVER["REMOTE_USER"]no value
_SERVER["REMOTE_PORT"]47354
_SERVER["REMOTE_HOST"]216.73.216.63
_SERVER["REMOTE_ADDR"]216.73.216.63
_SERVER["QUERY_STRING"]no value
_SERVER["PATH_TRANSLATED"]D:\wwwroot\yyjg.net\wwwroot\admin.php\index\view\aid\13693.html
_SERVER["PATH_INFO"]/index/view/aid/13693
_SERVER["LOGON_USER"]no value
_SERVER["LOCAL_ADDR"]172.16.121.93
_SERVER["INSTANCE_META_PATH"]/LM/W3SVC/1
_SERVER["INSTANCE_NAME"]WWWROOT
_SERVER["INSTANCE_ID"]1
_SERVER["HTTPS_SERVER_SUBJECT"]CN=www.yyjg.net
_SERVER["HTTPS_SERVER_ISSUER"]C=PL, O=Asseco Data Systems S.A., CN=Certum DV TLS G2 R39 CA
_SERVER["HTTPS_SECRETKEYSIZE"]2048
_SERVER["HTTPS_KEYSIZE"]256
_SERVER["HTTPS"]on
_SERVER["GATEWAY_INTERFACE"]CGI/1.1
_SERVER["DOCUMENT_ROOT"]D:\wwwroot\yyjg.net\wwwroot
_SERVER["CONTENT_TYPE"]no value
_SERVER["CONTENT_LENGTH"]0
_SERVER["CERT_SUBJECT"]no value
_SERVER["CERT_SERIALNUMBER"]no value
_SERVER["CERT_ISSUER"]no value
_SERVER["CERT_FLAGS"]no value
_SERVER["CERT_COOKIE"]no value
_SERVER["AUTH_USER"]no value
_SERVER["AUTH_PASSWORD"]no value
_SERVER["AUTH_TYPE"]no value
_SERVER["APPL_PHYSICAL_PATH"]D:\wwwroot\yyjg.net\wwwroot\
_SERVER["APPL_MD_PATH"]/LM/W3SVC/1/ROOT
_SERVER["IIS_UrlRewriteModule"]7.1.0871.0
_SERVER["HTTP_USER_AGENT"]Mozilla/5.0 AppleWebKit/537.36 (KHTML, like Gecko; compatible; ClaudeBot/1.0; +claudebot@anthropic.com)
_SERVER["HTTP_HOST"]www.yyjg.net
_SERVER["HTTP_ACCEPT_ENCODING"]gzip, br, zstd, deflate
_SERVER["HTTP_ACCEPT"]*/*
_SERVER["HTTP_CONNECTION"]close
_SERVER["FCGI_ROLE"]RESPONDER
_SERVER["PHP_SELF"]/admin.php/index/view/aid/13693.html
_SERVER["REQUEST_TIME_FLOAT"]1789690620.2412
_SERVER["REQUEST_TIME"]1789690620

PHP Credits

PHP Group
Thies C. Arntzen, Stig Bakken, Shane Caraveo, Andi Gutmans, Rasmus Lerdorf, Sam Ruby, Sascha Schumann, Zeev Suraski, Jim Winstead, Andrei Zmievski
Language Design & Concept
Andi Gutmans, Rasmus Lerdorf, Zeev Suraski, Marcus Boerger
PHP Authors
ContributionAuthors
Zend Scripting Language Engine Andi Gutmans, Zeev Suraski, Stanislav Malyshev, Marcus Boerger, Dmitry Stogov, Xinchen Hui, Nikita Popov
Extension Module API Andi Gutmans, Zeev Suraski, Andrei Zmievski
UNIX Build and Modularization Stig Bakken, Sascha Schumann, Jani Taskinen
Windows Port Shane Caraveo, Zeev Suraski, Wez Furlong, Pierre-Alain Joye, Anatol Belski
Server API (SAPI) Abstraction Layer Andi Gutmans, Shane Caraveo, Zeev Suraski
Streams Abstraction Layer Wez Furlong, Sara Golemon
PHP Data Objects Layer Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
Output Handler Zeev Suraski, Thies C. Arntzen, Marcus Boerger, Michael Wallner
SAPI Modules
ContributionAuthors
AOLserver Sascha Schumann
Apache 1.3 (apache_hooks) Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar, George Schlossnagle, Lukas Schroeder
Apache 1.3 Rasmus Lerdorf, Zeev Suraski, Stig Bakken, David Sklar
Apache 2.0 Filter Sascha Schumann, Aaron Bannert
Apache 2.0 Handler Ian Holsman, Justin Erenkrantz (based on Apache 2.0 Filter code)
Caudium / Roxen David Hedbor
CGI / FastCGI Rasmus Lerdorf, Stig Bakken, Shane Caraveo, Dmitry Stogov
CLI Edin Kadribasic, Marcus Boerger, Johannes Schlueter, Moriyoshi Koizumi, Xinchen Hui
Continuity Alex Leigh (based on nsapi code)
Embed Edin Kadribasic
FastCGI Process Manager Andrei Nigmatulin, dreamcat4, Antony Dovgal, Jerome Loyet
ISAPI Andi Gutmans, Zeev Suraski
litespeed George Wang
NSAPI Jayakumar Muthukumarasamy, Uwe Schindler
phpdbg Felipe Pena, Joe Watkins, Bob Weinand
phttpd Thies C. Arntzen
pi3web Holger Zimmermann
Sendmail Milter Harald Radi
thttpd Sascha Schumann
tux Sascha Schumann
WebJames Alex Waugh
Module Authors
ModuleAuthors
BC Math Andi Gutmans
Bzip2 Sterling Hughes
Calendar Shane Caraveo, Colin Viebrock, Hartmut Holzgraefe, Wez Furlong
COM and .Net Wez Furlong
ctype Hartmut Holzgraefe
cURL Sterling Hughes
Date/Time Support Derick Rethans
DB-LIB (MS SQL, Sybase) Wez Furlong, Frank M. Kromann
DBA Sascha Schumann, Marcus Boerger
DOM Christian Stocker, Rob Richards, Marcus Boerger
enchant Pierre-Alain Joye, Ilia Alshanetsky
ereg Rasmus Lerdorf, Jim Winstead, Jaakko Hyvätti
EXIF Rasmus Lerdorf, Marcus Boerger
fileinfo Ilia Alshanetsky, Pierre Alain Joye, Scott MacVicar, Derick Rethans
Firebird driver for PDO Ard Biesheuvel
FTP Stefan Esser, Andrew Skalski
GD imaging Rasmus Lerdorf, Stig Bakken, Jim Winstead, Jouni Ahto, Ilia Alshanetsky, Pierre-Alain Joye, Marcus Boerger
GetText Alex Plotnick
GNU GMP support Stanislav Malyshev
Iconv Rui Hirokawa, Stig Bakken, Moriyoshi Koizumi
IMAP Rex Logan, Mark Musone, Brian Wang, Kaj-Michael Lang, Antoni Pamies Olive, Rasmus Lerdorf, Andrew Skalski, Chuck Hagenbuch, Daniel R Kalowsky
Input Filter Rasmus Lerdorf, Derick Rethans, Pierre-Alain Joye, Ilia Alshanetsky
InterBase Jouni Ahto, Andrew Avdeev, Ard Biesheuvel
Internationalization Ed Batutis, Vladimir Iordanov, Dmitry Lakhtyuk, Stanislav Malyshev, Vadim Savchuk, Kirti Velankar
JSON Omar Kilani, Scott MacVicar
LDAP Amitay Isaacs, Eric Warnke, Rasmus Lerdorf, Gerrit Thomson, Stig Venaas
LIBXML Christian Stocker, Rob Richards, Marcus Boerger, Wez Furlong, Shane Caraveo
mcrypt Sascha Schumann, Derick Rethans
MS SQL Frank M. Kromann
Multibyte String Functions Tsukada Takuya, Rui Hirokawa
MySQL driver for PDO George Schlossnagle, Wez Furlong, Ilia Alshanetsky, Johannes Schlueter
MySQL Zeev Suraski, Zak Greant, Georg Richter, Andrey Hristov
MySQLi Zak Greant, Georg Richter, Andrey Hristov, Ulf Wendel
MySQLnd Andrey Hristov, Ulf Wendel, Georg Richter, Johannes Schlüter
OCI8 Stig Bakken, Thies C. Arntzen, Andy Sautins, David Benson, Maxim Maletsky, Harald Radi, Antony Dovgal, Andi Gutmans, Wez Furlong, Christopher Jones, Oracle Corporation
ODBC driver for PDO Wez Furlong
ODBC Stig Bakken, Andreas Karajannis, Frank M. Kromann, Daniel R. Kalowsky
OpenSSL Stig Venaas, Wez Furlong, Sascha Kettler, Scott MacVicar
Oracle (OCI) driver for PDO Wez Furlong
pcntl Jason Greene, Arnaud Le Blanc
Perl Compatible Regexps Andrei Zmievski
PHP Archive Gregory Beaver, Marcus Boerger
PHP Data Objects Wez Furlong, Marcus Boerger, Sterling Hughes, George Schlossnagle, Ilia Alshanetsky
PHP hash Sara Golemon, Rasmus Lerdorf, Stefan Esser, Michael Wallner, Scott MacVicar
Posix Kristian Koehntopp
PostgreSQL driver for PDO Edin Kadribasic, Ilia Alshanetsky
PostgreSQL Jouni Ahto, Zeev Suraski, Yasuo Ohgaki, Chris Kings-Lynne
Pspell Vlad Krupin
Readline Thies C. Arntzen
Recode Kristian Koehntopp
Reflection Marcus Boerger, Timm Friebe, George Schlossnagle, Andrei Zmievski, Johannes Schlueter
Sessions Sascha Schumann, Andrei Zmievski
Shared Memory Operations Slava Poliakov, Ilia Alshanetsky
SimpleXML Sterling Hughes, Marcus Boerger, Rob Richards
SNMP Rasmus Lerdorf, Harrie Hazewinkel, Mike Jackson, Steven Lawrance, Johann Hanne, Boris Lytochkin
SOAP Brad Lafountain, Shane Caraveo, Dmitry Stogov
Sockets Chris Vandomelen, Sterling Hughes, Daniel Beulshausen, Jason Greene
SPL Marcus Boerger, Etienne Kneuss
SQLite 3.x driver for PDO Wez Furlong
SQLite3 Scott MacVicar, Ilia Alshanetsky, Brad Dewar
Sybase-CT Zeev Suraski, Tom May, Timm Friebe
System V Message based IPC Wez Furlong
System V Semaphores Tom May
System V Shared Memory Christian Cartus
tidy John Coggeshall, Ilia Alshanetsky
tokenizer Andrei Zmievski, Johannes Schlueter
WDDX Andrei Zmievski
XML Stig Bakken, Thies C. Arntzen, Sterling Hughes
XMLReader Rob Richards
xmlrpc Dan Libby
XMLWriter Rob Richards, Pierre-Alain Joye
XSL Christian Stocker, Rob Richards
Zip Pierre-Alain Joye, Remi Collet
Zlib Rasmus Lerdorf, Stefan Roehrich, Zeev Suraski, Jade Nicoletti, Michael Wallner
PHP Documentation
Authors Mehdi Achour, Friedhelm Betz, Antony Dovgal, Nuno Lopes, Hannes Magnusson, Georg Richter, Damien Seguy, Jakub Vrana, Adam Harvey, Peter Cowburn
Editor Philip Olson
User Note Maintainers Daniel P. Brown, Thiago Henrique Pojda
Other Contributors Previously active authors, editors and other contributors are listed in the manual.
PHP Quality Assurance Team
Ilia Alshanetsky, Joerg Behrens, Antony Dovgal, Stefan Esser, Moriyoshi Koizumi, Magnus Maatta, Sebastian Nohn, Derick Rethans, Melvyn Sopacua, Jani Taskinen, Pierre-Alain Joye, Dmitry Stogov, Felipe Pena, David Soria Parra, Stanislav Malyshev, Julien Pauli, Stephen Zarkos, Anatol Belski, Remi Collet, Ferenc Kovacs
Websites and Infrastructure team
PHP Websites Team Rasmus Lerdorf, Hannes Magnusson, Philip Olson, Lukas Kahwe Smith, Pierre-Alain Joye, Kalle Sommer Nielsen, Peter Cowburn, Adam Harvey, Ferenc Kovacs, Levi Morrison
Event Maintainers Damien Seguy, Daniel P. Brown
Network Infrastructure Daniel P. Brown
Windows Infrastructure Alex Schoenmaker

PHP License

This program is free software; you can redistribute it and/or modify it under the terms of the PHP License as published by the PHP Group and included in the distribution in the file: LICENSE

This program is distributed in the hope that it will be useful, but WITHOUT ANY WARRANTY; without even the implied warranty of MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.

If you did not receive a copy of the PHP license, or have any questions about PHP licensing, please contact license@php.net.

医院经营管理网

医管智库MEDICAL TUBE

首页>医管智库>绩效管理
医保按病种分值付费下公立医院绩效改革提升运营实证研究
提交者:刘小丽 王 敏发表时间:2021-8-27点击次数:7094来源:圆桌论坛(杂志)

医院绩效管理


  医保付费模式是医保改革的核心。2020年10月,国家医保局印发《区域点数法总额预算和按病种分值付费试点工作方案的通知》称,将医保总额预算与点数法相结合,实现住院以按病种分值付费为主的多元复合支付方式,逐步建立以病种为基本单元,以结果为导向的医疗服务付费体系,倒逼医院加强内涵管理。然而,当前公立医院运营管理存在管理理念不强、管理手段较落后、信息化水平较低、管理人才不足、管理效果不佳等问题,无法满足当前政策和管理要求。面对疫情影响和医保付费模式改革的双重挑战,公立医院唯有全面提升运营管理水平才有出路,而绩效管理改革是运营管理提升的重中之重。
  
  一、公立医院运营管理现状
  
  (一)疫情导致公立医院经济运行压力骤升
  
  受新冠肺炎疫情影响,全国公立医院经济运行压力普遍骤增。根据国家统计信息中心近日发布的相关统计数据,全国公立医院总诊疗人次同比下降13.0%,出院人次数同比下降12.8%,病床使用率同比下降11.9个百分点。业务量大幅下滑的同时,公立医院承担疫情防控任务,各项支出无明显减少,导致公立医院经济运行压力巨大。
  
  (二)公立医院当前运营管理水平存在不足
  
  当前公立医院运营管理通常由财务部门兼管,较少像华西医院等设立专职的运营管理部门。长期以来,由于财会人员专业局限、转型困难,业财融合程度不够,公立医院运营管理普遍存在管理理念不强、管理手段较落后、信息化水平较低、管理人才不足、管理效果不佳等问题,无法满足当前政策和管理要求。当前,国内公立医院运营管理虽有局部突破,但总体仍未达较高水平。
  
  二、医保按病种分值付费模式下公立医院运营管理面临的新挑战
  
  (一)要求公立医院转变诊疗行为,加强病案信息化管理
  
  随着医保付费模式的转变,公立医院必须严格执行标准的诊疗规范,规避过度诊疗,并采取措施有效降低药品和耗材占比,优化收入结构,降低次均费用,从而提升运营效益和医疗服务质量。当前付费模式的偿付依据均主要来源于病案系统信息,故对医院病案管理水平要求不断提高。准确填写适合的疾病编码和相应手术操作编码,才能获取合适的付费标准。
  
  (二)极大增加公立医院经济运营压力和经营风险为保障公立医院的公益性,其资金来源除了自身提供医疗服务从患者收取的诊疗费用外,还有两个非常重要的来源:财政补助资金和医保偿付基金。而医保偿付基金的比重高,对公立医院的经济运营保障意义重大。在按病种分值付费模式下,“超支不补,结余留用”,对公立医院的经济运营状况产生了极大压力,相应增大了经营风险。
  
  (三)要求公立医院转变绩效管理模式,加强成本管控按病种分值付费为主的多元复合式医保付费模式下,公立医院亟须建立全新的绩效管理体制,更加注重成本管控、次均费用控制、工作质量和工作效率,重视考核管理,因此需要打破以往简单的收支盈余绩效分配机制,将多种绩效管理工具组合实施,充分发挥组合激励作用,发挥规范诊疗行为的作用,保障公立医院可持续发展。同时,由于运营管理压力巨大,医保付费模式的转变也迫使医院必须加强内涵建设,强化运营成本管控,将运营成本管控有机结合到绩效管理体制中来,联合发挥作用。
  
  三、医保按病种分值付费模式下公立医院运营管理提升总体框架
  
  (一)推进全面预算管理,落实预算控制
  
  作为管理会计的重要工具,全面预算管理对公立医院运营管理提升发挥基础性作用。只有通过对医院所有收支项目全面纳入预算管理,全院所有科室全员参与,利用信息化手段实现全面预算编制、执行、调整、分析、考核全流程管控,才能不断提高医院全面预算管理的精细化水平,切实做到“无预算不支出、超预算不支出”。预算控制作为成本管控的重要手段得以发挥,才能最大限度发挥资产利用效益,降低运营成本。(二)加强成本管控,综合监控运营成本
  
  充分发挥事前预算控制、成本预测和可行性论证,事中定额管理、费用审核控制,事后强化成本考核,实现事后监督的全流程成本管控措施,综合监控运营成本。其中,对于事前预算控制和可行性论证,尤其要做实经济效益、社会效益等绩效评估,充分保障成本开支的必要性,减少非必要支出和成本浪费。对于事中定额管理和费用审核,则需要在充分调查、深入研究的基础上,制订不同类别成本开支的限额标准,对限额内成本常规审核,严控限额外成本开支;同时加强事后成本考核,为进一步落实考核、挂钩绩效管理奠定数据基础。
  
  (三)构建基于RBRVS+DRG/DIP+KPI+成本管控的全面绩效管理体制
  
  在推进实施全面预算管理、成本管控和DRG/DIP/医保精细化管理的基础上,运用前述管控措施提供的监管数据,结合运用RBRVS、KPI等主流绩效管理工具,构建基于“RBRVS+DRG/DIP+KPI+成本管控”的全面绩效管理体系:实现医护技药勤五大职系垂直管理;加强关键指标考核,落实管理责任;重点关注成本管控、医保管理指标、次均费用等综合指标体系;搭建全面绩效管理信息系统,实现基础数据自动对接,绩效管理过程自动化,从而极大提高科学水准和管理效率。


医院绩效管理
  
  四、深圳市某公立医院全面绩效管理改革助推运营管理提升实践经验
  
  (一)实施全面绩效管理改革的背景该院是一所集急救、医疗、教学、科研、预防保健、康复为一体的三级综合医院。现行绩效考核方案主要是基于工作量和经营效益,结合质量考核及满意度评价等因素进行分配,存在诸多弊端,制约了该院发展:①工作量绩效条目众多,缺乏科学评价工具,未能全面体现劳动技术价值、工作质量和难易程度、医疗服务项目的相对风险程度;②未实现医、护、技独立核算,不利于垂直管理;③二次分配缺乏系统方案,科主任、护士长纳入科室二次分配,权力过大,不利于科室团结稳定;④未能实现信息化管理,工作量大、核算滞后且易出错。
  
  (二)该院全面绩效管理改革的内容为解决上述弊端,通过调整绩效考核方案助推精细化运营管理,该院于2020年度实施全面绩效管理改革项目,项目内容包括三方面:基于“RBRVS+DRG/DIP+KPI+成本管控”的医、护、技绩效管理方案,基于岗位价值评价的职能科室绩效管理方案和绩效管理信息系统。
  
  (三)该院全面绩效管理改革的精髓
  
  该院全面绩效管理改革符合深圳市卫生健康委于2019年10月16日发布的《关于征求公立医院薪酬分配指导意见和党政主要负责人目标年薪制实施方案意见的函》的文件精神,创新性整合使用RBRVS、DRG/DIP、KPI、成本管控等现代医院绩效管理工具,且紧扣医保付费模式改革的方向和现代医院管理制度建设的导向,因此也被纳入深圳市龙岗区卫生健康局于2020年4月发布的《龙岗区卫生经济管理提升计划(2020-2021年)》中,作为全区试点,形成可行性经验后推广全区。该院全面绩效管理改革方案精髓如下。
  
  1.一套系统,关注效率全面绩效管理信息系统与院内HIS、LIS、PACs、财务、人事、手麻、消毒供应等人、财、物信息系统进行一体化对接,自动获取数据完成计算,实现精准高效。该院当前正在引入DRG/DIP/医保精细化管理信息系统,待其正式上线运作后,则可实现DRG、DIP、医保监管数据(如科室CMI、总权重、时间消耗指数、病种分值盈亏情况、医保合规性指标等)的定期生成和自动对接,从而极大提高绩效管理效率。
  
  2.二次分配,注重公平一是将科主任、护士长从科室二次分配中剥离出来,由医院单独设置KPI进行考核,设定绩效分配基数,系数与考核结果挂钩;二是医疗组间、组内、医技/护理单元内统一设置分配指标,统筹实现公平公正,导向明确。
  
  3.三款工具,做到科学权威一是RBRVS理念贯彻于执行和判读点值费率,根据是否医师亲自操作、侵袭性、手术级别等因素将全院所有收费项目划分为68类,分别赋予不同的点值费率,充分体现工作质量和难度系数。二是DRG/DIP管控成效按30%挂钩科室绩效,确保DRG/DIP管控成效及时转化为绩效管理数据。三是对科主任和护士长设置综合KPI体系,落实管理责任。其中,对科主任设置KPI,既考核本人相关指标,也考核科室总体指标;对护士长则着重考核人员、材料等运营管理效率,同时设置科主任考核护士长协作情况,确保医护团结。
  
  4.四项考核,着眼成本管控在科室考核指标设置上,充分契合当前医保付费模式改革的导向,设置高值耗材费率、人事成本费率、一般成本费率和手术成本费率等四项考核指标,贯彻落实成本定额管理,实现提质增效。尤其针对高值耗材费率超过20%的科室,设置超额累进扣罚比率,当费率降低至30%以下时,相应予以奖励,有力管控不合理的运营成本。
  
  5.五大职系,落实垂直管理医护技药勤五大职系独立核算,落实垂直管理。其中,医师绩效来自点值费率、成本管控和DRG/DIP管控成效,护士来自护理时数、项目点数、收入费率和成本管控,技师采用工作负荷制,药师采用处方单价制,职能采用岗位价值评价。五大职系分别结合其特点,采用不同方法实施独立核算,真正做到各司其职、各展所长。
  
  (四)取得阶段性成效
  
  该院全面绩效管理改革取得了全院员工的普遍欢迎和大力支持,实施改革后,员工绩效水平总体得到明显提高,局部分配趋向合理,有效助力该院精细化运营管理水平的提升。2020年12月,在深圳市卫生健康委主办的第一届深圳市现代医院管理创新“勒杜鹃”评比中,我院“全面绩效管理改革助推医院精细化管理”项目从200余个参赛项目中脱颖而出,荣获管理制度组三等奖。
  
  五、结论与建议
  
  (一)运营管理提升势在必行,全面绩效管理是核心医保按病种分值付费模式下,运营管理提升势在必行;而运营管理提升,有赖于推进实施全面预算管理、成本管控和DRG/DIP/医保精细化管理。在此基础上,综合运用RBRVS、KPI等主流绩效管理工具,构建基于“RBRVS+DRG/DIP+KPI+成本管控”的全面绩效管理体系,是医保按病种付费模式下公立医院的必然选择。
  
  (二)信息化水平势必提升,系统与数据整合是关键无论是精细化的DRG/DIP/医保精细化管理信息系统,还是全面绩效管理信息系统,都不可能独立运作,如何对系统功能进行整合,对系统间数据进行对接,实现管理系统与HIS、LIS、PACs、财务、人事、手麻、消毒供应等人、财、物基础信息系统的一体化对接,是确保管理系统精准高效的前提。对医院而言,基础信息数据的归集与整合至关重要
  
  (三)全面改革乃大势所趋,积极主动拥抱变革是出路当前医疗体制改革步入深水区,不仅在医保付费模式方面改革政策频出,其他相关配套改革机制也在逐步建立。建立健全现代医院管理制度,是符合“双区驱动”和大湾区建设的正确导向。对于医院而言,变革是无可回避的大势所趋,只有抛弃沉疴,摈弃陋习,积极主动拥抱变革,方能在当前形势下谋求健康、可持续发展。
  
  六、结语
  
  付费方式改革是医保改革的重要手段,而医保按病种分值付费模式改革是当前医保付费制度改革的重头戏,随着公立医院高质量发展的要求不断提升,对医院精细化运营管理的要求也随之加码。医保按病种分值付费模式下,公立医院已经正式从步入“成本时代”。公立医院只有应时而变,顺势而为,牢牢把握住成本管控、预算控制、绩效管理这“三板斧”,树立“合理诊疗、精细运营”的正确导向,才能在变革中谋求长足发展。
  
  武汉九鼎顾问是一家医院绩效管理咨询公司,独创的“医院SEP战略绩效管理模式”为多家医院解决了医院利益与员工利益的矛盾,如有咨询需求请拨打热点:027-82444583,或扫描以下二维码添加客服微信直接咨询。
  

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