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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 5591461
bytes_received 119360866
packets_sent 129980
packets_received 1445981
protocol_overhead_in 5783924
protocol_overhead_out 519920
bytes_received_ok_packet 0
bytes_received_eof_packet 0
bytes_received_rset_header_packet 565128
bytes_received_rset_field_meta_packet 0
bytes_received_rset_row_packet 337626
bytes_received_prepare_response_packet 80805891
bytes_received_change_user_packet 37294217
packets_sent_command 64374
packets_received_ok 0
packets_received_eof 0
packets_received_rset_header 62792
packets_received_rset_field_meta 0
packets_received_rset_row 63451
packets_received_prepare_response 1196914
packets_received_change_user 121592
result_set_queries 62484
non_result_set_queries 878
no_index_used 32442
bad_index_used 0
slow_queries 0
buffered_sets 62484
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 59108
rows_fetched_from_server_ps 0
rows_buffered_from_client_normal 59108
rows_buffered_from_client_ps 0
rows_fetched_from_client_normal_buffered 59108
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 225
rows_affected_ps 0
rows_skipped_normal 59108
rows_skipped_ps 0
copy_on_write_saved 72947
copy_on_write_performed 1080536
command_buffer_too_small 0
connect_success 308
connect_failure 0
connection_reused 0
reconnect 0
pconnect_success 0
active_connections 18446744073709551310
active_persistent_connections 0
explicit_close 307
implicit_close 0
disconnect_close 0
in_middle_of_command_close 0
explicit_free_result 62483
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 104765
proto_text_fetched_short 355137
proto_text_fetched_int24 25879
proto_text_fetched_int 32114
proto_text_fetched_bigint 257
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 544320
proto_text_fetched_blob 0
proto_text_fetched_enum 2267
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 307
com_init_db 308
com_query 63451
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 308
com_stmt_fetch 0
com_deamon 0
bytes_received_real_data_normal 35649821
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-60a56984-32a1-4817-bd03-56e1153c8ead
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
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_REQUEST["_URL_"]
Array
(
    [0] => index
    [1] => view
    [2] => aid
    [3] => 15176
)
_GET["aid"]15176
_GET["_URL_"]
Array
(
    [0] => index
    [1] => view
    [2] => aid
    [3] => 15176
)
_COOKIE["PHPSESSID"]psifpur1bggptbmik2hce9stk3
_SERVER["_FCGI_X_PIPE_"]\\.\pipe\IISFCGI-60a56984-32a1-4817-bd03-56e1153c8ead
_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
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_SERVER["NUMBER_OF_PROCESSORS"]2
_SERVER["OS"]Windows_NT
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_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
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_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/15176.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/15176.html
_SERVER["REQUEST_METHOD"]GET
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_SERVER["PATH_INFO"]/index/view/aid/15176
_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
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_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_COOKIE"]PHPSESSID=psifpur1bggptbmik2hce9stk3
_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/15176.html
_SERVER["REQUEST_TIME_FLOAT"]1789695082.9085
_SERVER["REQUEST_TIME"]1789695082

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

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国务院发文:分级诊疗体系建设迎来重要部署
提交者:发表时间:2026-4-13点击次数:458来源:国家卫健委
  近日,国务院办公厅印发《关于加快建设分级诊疗体系的若干措施》(以下简称《若干措施》),明确了分级诊疗体系建设的方向,提出了具体举措,对进一步优化医疗卫生服务体系、更好满足人民日益增长的美好生活需要具有重要意义。

  一、出台背景

  分级诊疗体系建设是科学配置医疗资源、促进基本医疗卫生服务均等化、更好满足人民群众看病就医需求的重要举措。党的二十届三中全会通过的《中共中央关于进一步全面深化改革、推进中国式现代化的决定》提出“加快建设分级诊疗体系”。此时出台《若干措施》,主要有两个方面的考虑:一是以满足群众就近就便看病就医需求为出发点,提出完善分级诊疗协同机制、引导群众基层首诊、加强转诊管理、完善保障措施等具体举措,落实新时代党的卫生与健康工作方针,加快推进优质医疗资源下沉和区域均衡布局,提升基层医疗卫生服务能力。二是巩固2015年以来分级诊疗制度建设取得的积极成效,完善医疗卫生服务体系,推动医疗卫生服务资源高效配置,为群众提供更便捷、更高效、更优质医疗卫生服务。

  二、主要工作任务

  《若干措施》从4个方面提出13条具体措施。

  (一)以紧密型医联体为抓手完善分级诊疗协同机制。一是优化医疗卫生机构功能定位和结构布局。动态消除基层医疗卫生服务空白,发挥二级医院在三级医院和基层医疗卫生机构之间的桥梁纽带作用,引导三级医院聚焦急危重症和疑难复杂疾病加强转诊会诊和住院服务。二是推动紧密型医联体提质扩面。全面推开紧密型县域医共体、紧密型城市医疗集团。三是加强紧密型医联体内医疗资源共享。推动形成医联体内医疗、运营、信息管理一体化,促进医疗卫生服务系统连续。

  (二)以常见病、慢性病为重点引导群众基层首诊。一是加强基层常见病诊疗和慢性病管理。通过医联体牵头医院在基层医疗卫生机构开设常见病、慢性病门诊,专家团队的普通门诊向基层延伸,为患者提供慢性病医防融合服务等方式,提高基层医疗机构对群众的吸引力。二是强化上级医院帮扶机制。通过上级医疗机构持续帮扶,提高基层医疗机构承接能力。三是提升家庭医生签约服务质效。加强签约医生与居民的长期稳固联系和就诊指导。

  (三)以提升就医连续性为导向加强转诊服务管理。一是明确转诊规则。以便利群众转诊为导向,完善各级转诊规则,强调发挥医疗机构和临床医师评估作用。二是畅通首诊后患者转诊渠道。推动医疗机构设立转诊中心,地市级及以上医院与医联体建立协作关系,畅通首诊后患者转诊渠道。三是强化医保政策引导。加强异地就医直接结算管理服务,推进省内异地就医住院费用纳入就医地按病种付费管理,引导患者合理就医需求。

  (四)完善分级诊疗多元保障措施。一是加快完善紧密型医联体发展保障机制。从落实财政补助政策、完善薪酬制度、医保支持等方面提出紧密型医联体发展的保障措施。二是完善基本医保差异性支付政策。因地制宜拉开各层级医疗机构报销比例。合理确定不同等级、类型医疗机构的支付系数。三是完善医疗卫生服务相关价格政策。落实基层医疗卫生机构一般诊疗费政策。四是加强宣传引导。提升群众对分级诊疗的认知度和认可度,树立规范有序就医理念。

  三、做好组织实施

  为确保各项任务顺利实施,《若干措施》提出了具体工作要求。一是加强组织领导。各地区、各有关部门要落实工作责任,及时研判分析新情况新问题,确保分级诊疗体系建设取得成效。二是加强政策保障。地方各级人民政府要加强县区、基层医疗卫生机构运行保障,强化基层医疗卫生队伍建设,为分级诊疗体系建设提供坚实支撑。三是加强工作协同。国家卫生健康委将会同有关部门充分发挥相关工作协调机制作用,加强协同配合,及时总结推广经验做法,确保各项政策措施落实到位。


医院绩效咨询


  《关于加快建设分级诊疗体系的若干措施

  为深入贯彻新时代党的卫生与健康工作方针,按照建立中国特色基本医疗卫生制度、深化医药卫生体制改革要求,以满足群众就近就便看病就医需求为出发点,以实施医疗卫生强基工程为支撑,推进医疗卫生人员、服务下沉和基层能力提升,推动医疗卫生服务资源高效配置,加快建设分级诊疗体系,提出如下措施。

  一、以紧密型医联体为抓手完善分级诊疗协同机制

  (一)优化医疗卫生机构功能定位和结构布局。统筹行政区划调整、人口变化趋势等因素,持续优化基层医疗卫生机构建设布局。对未设置社区卫生服务中心的街道,根据地方实际依次通过辖区内政府办一级医院、其他医疗卫生机构转型为社区卫生服务中心,由二、三级医院延伸提供服务和确有必要的按标准新建等途径,动态消除基层医疗卫生服务空白。二级医院要稳定设置、优化功能,加强常见病专业建设,拓展康复、护理、安宁疗护、医养结合等服务,强化在三级医院和基层医疗卫生机构之间的桥梁纽带作用。三级医院要聚焦急危重症和疑难复杂疾病,加强转诊会诊和住院服务,逐步酌减常见病复诊和诊断明确、病情稳定的慢性病等普通门诊。其中,国家医学中心、国家区域医疗中心、省级区域医疗中心、省级及以上医院要发挥专科优势,以区域死亡率高、外转率高的疾病为重点,提升区域医疗卫生服务能力整体水平,进一步减少跨省跨区域就医。

  (二)推动紧密型医联体提质扩面。加快建设紧密型医联体(包括紧密型县域医共体、紧密型城市医疗集团),推动医疗、运营、信息管理一体化。城市地区重点推广区社一体、以市带区的紧密型城市医疗集团协作模式,已完成网格化布局、运行良好的紧密型城市医疗集团要在现有工作基础上进一步提升质效。县域内推进以城带乡、以乡带村和县乡一体、乡村一体的紧密型县域医共体建设。鼓励有条件的中医医院牵头组建紧密型医联体。到2030年,以紧密型医联体为抓手的分级诊疗协同机制基本建立,医疗卫生服务同质化水平和便利性、可及性进一步提高,就医秩序更加合理规范。

  (三)加强紧密型医联体内医疗资源共享。统筹现有医疗资源,建设医学影像、心电诊断、医学检验、消毒供应、病理诊断、药品供应和药学服务等资源共享中心。推动紧密型医联体内处方流转。建立紧密型医联体内医院和基层医疗卫生机构之间的药品配备衔接联动机制,健全药品供应保障机制和短缺预警处置机制,保障基层用药需求。加快推进“医保药品云平台”建设,更好满足群众和基层医疗卫生机构的急需药品使用需求。紧密型医联体牵头医院(以下简称牵头医院)派出人员到基层医疗卫生机构提供服务的,要保障所需药品配备到基层医疗卫生机构。牵头医院要切实承担医疗质量控制责任,加强对基层医疗卫生机构质量控制的监督管理。

  二、以常见病、慢性病为重点引导群众基层首诊

  (四)加强基层常见病诊疗和慢性病管理。紧密型医联体内上级医院要在基层医疗卫生机构开设高血压、糖尿病、慢性阻塞性肺疾病等常见病、慢性病门诊,提供诊疗和健康管理服务,并将专家团队普通门诊向基层医疗卫生机构延伸,逐步提高常见病、慢性病基层就诊比例。对于符合条件的慢性病患者,基层医疗卫生机构单次可开具不超过12周用药的长期处方。基层医疗卫生机构要开展慢性病防控,推广健康生活方式和体重管理,促进多病同防共管,加强慢性病高风险人群早期发现和干预,为慢性病患者提供分类分级健康管理和科普宣教。加强中医康复方案和技术规范在基层的应用。探索适宜基层的门诊按人头付费与慢性病管理相结合的多元复合支付方式。

  (五)强化上级医院帮扶作用。推动二、三级医院向基层医疗卫生机构派驻主治医师及以上职称人员提供常年服务,并逐步覆盖所有社区卫生服务中心、乡镇卫生院。三级医院定期安排优势专科团队在所支援的基层医疗卫生机构开设“全科+专科”联合门诊。推动常态化巡回医疗在医疗资源薄弱地区实现全覆盖,推广移动医疗和远程医疗。引导国有企业办医疗机构为企业边远作业区周边群众提供医疗服务。

  (六)提升家庭医生签约服务质效。支持上级医院派驻医务人员、退休医务人员、社会办医疗机构医务人员等依托基层医疗卫生机构为居民个人或家庭提供签约服务,逐年扩大家庭医生签约服务供给,提高签约率和履约率。推进“互联网+签约”,促进形成长期稳定签约关系。根据签约居民健康需求,提供疾病预防、基本医疗、转诊、用药指导等服务,在中医医师指导下提供中医药治未病服务,因地制宜细化基本服务包和个性化服务包内容。加强基层门诊付费与签约服务政策联动,基本服务包按规定纳入医保支付;个性化服务包由签约基层医疗卫生机构按程序向县级卫生健康部门备案,费用由个人支付。鼓励有条件的地方加快发展更高水平的家庭医生签约服务。

  三、以提升就医连续性为导向加强转诊服务管理

  (七)明确转诊规则。各地区要组织卫生健康、医保等部门立足本地医疗资源配置、服务能力和人群疾病谱情况,按照分级诊疗原则和常见病、慢性病分级诊疗服务技术方案,相应制定省域内、地市内和医联体内转诊规则并督促落实。转诊规则应注重保障医患双方合法权益,细化明确不同情形的转诊路径。发挥医疗机构和临床医师引导患者有序转诊的作用,原则上由二、三级医院副主任医师及以上职称人员评估患者跨统筹地区、跨省异地就医的必要性。

  (八)畅通首诊后患者转诊渠道。紧密型医联体要为基层医疗卫生机构首诊后患者转诊提供便利,牵头医院要为基层医疗卫生机构预留一定比例的号源和床位,并及时接诊经基层转诊患者。推进紧密型医联体内住院一体化管理,上级医院要主动为恢复期、康复期等的患者提供下转服务,并通过定期联合查房、远程会诊等方式指导后续治疗。地市级及以上医院要发挥专科优势,与所在地区的牵头医院建立协作关系,为患者转诊提供支持。医疗机构要强化转诊服务统一管理,设立转诊中心或指定固定部门承担患者转诊服务工作,到2027年实现全覆盖。

  (九)强化医保政策引导。统筹地区内经基层医疗卫生机构逐级转诊的参保患者,在上级医院的住院起付线可连续计算;由上级医院下转至基层医疗卫生机构的住院患者,同一疾病周期内不再另设住院起付线。进一步强化异地就医直接结算管理服务,跨省临时外出就医人员报销水平与参保地同级别医疗机构报销水平保持合理差异。稳步推进将省内及跨省异地就医住院费用纳入就医地按病种付费管理。逐步建立全国统一的医保医疗服务项目目录和医用耗材目录。

  四、完善分级诊疗多元保障措施

  (十)加快完善紧密型医联体发展保障政策。按规定落实对符合区域卫生规划的医疗卫生机构的财政补助政策。落实“两个允许”要求,完善符合紧密型医联体发展要求的薪酬制度,统筹平衡紧密型医联体内不同医疗机构之间、医疗机构内不同科室之间及科室内部的薪酬关系,注重医务人员的稳定收入和有效激励。落实对符合条件的紧密型县域医共体总额付费政策。及时将符合条件的基层医疗卫生机构纳入医保定点管理。

  (十一)完善基本医保差异性支付政策。健全总额付费动态调整机制,年度新增医保基金适当向基层医疗卫生机构倾斜。各地可综合考虑医保基金保障能力、群众就医需求、基层医疗卫生服务能力,合理确定基层医疗卫生机构住院起付线。因地制宜适当拉开参保人员在不同等级医疗卫生机构的住院报销水平,原则上统筹地区内医疗卫生机构住院报销比例逐级拉开10个百分点左右的差距。加强参保人员门诊就医保障。具备条件的地方,可按分级诊疗导向酌情拉开参保人员在不同等级医疗卫生机构的门诊报销水平。合理确定不同等级、类型医疗卫生机构的支付系数,加大对基层倾斜力度。

  (十二)完善医疗服务价格等政策。落实基层医疗卫生机构一般诊疗费政策。分类优化医疗服务价格体系,对一、二级手术和护理、影像检查、检验等医疗服务价格项目,适当缩小不同等级医疗卫生机构之间的价格差距;对换药、注射、输液、采血等均质化程度高的医疗服务价格项目,加快推进区域内价格相对协同。加快推进以省为单位规范基层病种范围,实行统筹地区内不同等级医疗卫生机构基层病种“同病同付”。结合落实立项指南,支持基层医疗卫生机构提供上门服务、安宁疗护、家庭病床等医疗服务,上门服务费由基层医疗卫生机构自主确定,按规定报医保部门备案。

  (十三)加强宣传引导。积极宣传分级诊疗有关政策措施和基层医疗卫生服务能力建设成效,普及看病就医指引指南、慢性病防控知识,宣传家庭医生签约服务的作用和效果,推动提升人民群众对分级诊疗的认知度和认可度,树立规范有序就医理念。

  各地区、各有关部门要加强组织领导,落实工作责任,及时研判分析新情况新问题,确保分级诊疗体系建设取得成效。地方各级人民政府要加强县区、基层医疗卫生机构运行保障,强化基层医疗卫生队伍建设,为分级诊疗体系建设提供坚实支撑。国家卫生健康委要会同有关部门充分发挥相关工作协调机制作用,加强协同配合,对各地工作开展指导,及时总结推广经验做法,确保各项政策措施落实到位。

  武汉九鼎医院管理顾问是一家集医院发展战略、医院文化、医院人力资源、医院绩效管理等咨询模块为一体的医院管理咨询公司。如有咨询需求请拨打热线:027-82444583。

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