DRGs付费、按人头付费…浙江这场医保支付改革会带来什么-行政管理-医院绩效咨询,医院绩效管理,医院管理咨询 -九鼎医院管理顾问

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DRGs付费、按人头付费…浙江这场医保支付改革会带来什么

提交者：九鼎医管发表时间：2019-11-22点击次数：3660来源:浙江新闻

医院文化建设

蹚过深水区，浙江医药体制改革驶入快车道。

7月17日，记者从全省县域医共体基本医疗保险支付方式改革新闻发布会上获悉，我省将全面推行总额预算管理下的多元复合式医保支付方式改革：对住院医疗服务，主要按DRGs（疾病诊断相关分组）点数法付费；对长期、慢性病住院医疗服务，逐步推行按床日付费；对门诊医疗服务，探索结合家庭医生签约服务，实行按人头付费。

会上正式公布《关于推进全省县域医共体基本医疗保险支付方式改革的意见》（下称《意见》）主要内容。浙江省医疗保障局局长杨烨表示，意见的出台，标志着我省在全国率先全面启动医共体支付方式改革，浙江也成为全国首个在全省范围内推进住院医疗服务主要按DRGs点数法付费的省份。

医保支付方式的变革，会触及到医疗服务的方方面面。医院、医生、患者都会受到哪些影响？这项“刀刃向内”的改革，对浙江又意味着什么？

破解看病贵，住院病人按DRGs点数法付费

医院文化建设

面对医药体制改革，老百姓最关心的是，居高不下的药费如何降下来。

一直以来，“看病难”“看病贵”饱受诟病，即便随着全国各地药品零差率、医药耗材零差率政策的实施，“感个冒花上千检查”现象也屡见不鲜。究其因，与医保对医院按项目付费的结算办法有极大关系。

本次改革最大的亮点，是对住院医疗服务实施DRGs点数法付费，以激发医共体和医生控制医疗成本的内生动力。

什么是DRGs点数法？不同于医保现行对医院按项目付费的结算办法，DRGs点数法是按照疾病种类、严重程度、治疗手段等因素，先把疾病分为若干组，然后根据历史数据设定每组的点数，医院每收治一个病人就能得到相应点数，每一个点数的价值（即点值）是根据医保基金年度支出总额除以本统筹区所有医院的总点数得出的，年底医保部门根据各家医院得到的总点数乘以点值，计算得出每个医院实际应得费用。

“就相当于以前生产队计工分，医保定工分、医院挣工分。”浙江省卫生健康委巡视员马伟杭说，DRGs点数法付费改革目的是鼓励医院多看病，多使用性价比高的药物和材料，减少不必要的检查，节约医疗成本，增加医院收入，提高医生薪酬水平，激励医生成为人民群众健康和医保基金的“双守门人”。

事实上，浙江一些地区已经率先开始试点。不久前，家住金华市多湖街道的袁先生突发急症，在金华市中心医院进行住院治疗。细心的他发现，主治医生在填写其病案首页记录时非常详细，和他几年前住院时的情况完全不同。

这与金华市试点DRGs付费相关改革有关。因为，病案首页的信息就是DRGs的来源，这也要求医生在诊断时务必准确无误，为患者敲定相应病组的治疗方案，不让患者多花一分冤枉钱。

2016年7月，金华医保局对金华市区7家主要医院的住院医疗服务，开展以DRGs付费为核心，同时综合运用总额预算、疾病分组、点数记分、智能考核等手段的多元复合式付费改革试点，将此做法提炼为按“病组点数法”付费。

2018年，在分析全市8个统筹区24个月115万余病例数据（其中市区30个月）基础上，金华市对疾病诊断分组器系统作了进一步完善。通过组织与医疗机构沟通谈判，按国际、国内分组技术测算，各方形成634个疾病分组，实现了金华市住院疾病病例全覆盖。

为合理确定疾病分组支付标准，金华市利用大数据，将2016年6月前18个月（2018年为30个月运行数据）各病组的平均历史成本确定为每一病组的平均支付标准（病组支付标准包括医保基金和个人付费在内的全部医疗费用），形成医保、医院、医生、患者四方认同的成本“标尺”。同时，借鉴国外开展病组付费实践经验，逐步形成各方认同的市场成本标准。

待病组支付标准确定后，年度医保预算总额不再细分到各医疗机构，而是将病组、床日、项目等各种医疗服务的支付标准，按相对比价关系用点数形式体现，通过“点数法”调控各医院的医疗基金支付额度。

经过近3年的改革，金华市医保“病组点数法”付费改革实现了参保群众、医疗机构、医保基金三方共赢目标。数据显示，金华市均次住院费用持续下降，患者自费自负医疗费用增长率同步下降。2017年度，金华市区患者自付费用负增长达7.46%，减少群众现金负担近亿元。

“无形中，DRGs对医务人员合理用药、合理检查、合理安排住院、依法依规收费等行为起到规范作用。”金华市中心医院院长袁坚列说，DRGs推动住院医疗服务从数量付费走向质量付费，重拾医生的劳动价值。

今年5月20日，国家医疗保障局召开疾病诊断相关分组（DRGs）付费国家试点工作启动视频会，确定DRGs付费国家试点城市30个，我省金华纳入国家试点。

对门诊医疗服务来说，这次改革将探索结合家庭医生签约按人头付费。

“按人头付费”就是按一定的区域内对应的人口数量，把人头费用包干给医共体。其中，与家庭医生签约的，优先包干，既方便群众就医，又能以最低的医药支出来达到治好病的目的。同时，合理拉开统筹区内外和不同等级医疗机构报销比例，依规引导参保人员在基层就诊，形成分级诊疗的格局。

一年多来，家住安吉递铺街道的张大伯觉得自己幸福指数爆棚。他的家庭医生小何隔三差五主动来关心他的身体，叮嘱他“高血压要好好吃药”“要多运动还要健康饮食”。原来，这与安吉县试点医保费用“按人头付费”的改革不无关系。

2018年，乘着医共体建设的东风，安吉县将全县15个乡镇（街道）卫生院、125个村级服务站组成以县人民医院、县中医院、县第三人民医院为牵头医院的3个医共体。同时，巧妙运用医保这个指挥棒，在全省率先试点医保费用“按人头总额包干”支付改革。

该县将居民医保、职工医保当年度统筹基金纳入按人头付费预算，除去大病保险费、责任医生签约服务费、农民健康体检经费以及提取3%风险金后的剩余资金，按各医共体包干人数折算人头支付定额标准，确定三个医共体的包干额，来负责承担医共体辖区参保人员当年度门诊、住院符合医保规定的医疗费用中统筹基金部分的支出。

为进一步鼓励医疗机构合理控费，安吉县在顶层设计时划定多项“红线”，比如“医保总支出合理下降越多，年薪上浮越多，否则按同比例扣除”“医共体无结余的取消牵头医院院长当年度绩效年薪，第二年仍无结余撤销牵头医院院长职务”“医共体组成单位连续两年医保无结余的撤销该单位院长职务”……这些在安吉医共体实施方案中明文规定的内容，给医共体牵头单位和成员单位院长带来不小压力，让他们不得不主动控费。

“实施一年多来，医共体成员单位控费氛围基本形成。”安吉县医保局副局长朱晖说，最直观的表现是公立医院收入结构得到改善，医护人员收入相应提高。据悉，2018年度安吉县公立医院医疗总费用增长4.97%，增长幅度远低于省级标准的10%，门急诊均次费、住院均次费用、药占比、百元消耗卫生材料、检查检验收入等同比下降。同时，医共体内医护人员的薪酬年均增长了1万元至两万元。

“群众就医负担进一步减轻，获得感进一步加强，群众满意度达95%左右。”安吉县医保局相关负责人说。

深化新医改，以医保支付改革撬动医药体制改革

《意见》要求，要全面推行总额预算管理，形成约束激励机制。

总额预算管理，就是以各统筹区（浙江有71个统筹区）上一年度医保基金收支为基础，综合考虑经济增长水平、下一年度收入预算、重大政策调整和医疗服务数量、质量、能力等因素，来确定下一年度医保基金总额预算。这个总额定下后，再采取不同的医保支付方式。

据介绍，总额预算管理按适当比例“结余留用、超支分担”。对医院来说，如果分掉的医保“蛋糕”花光了，超出的部分就只能自己“掏腰包”，但如果有结余，则留作自用。这就为医院主动控费戴上了“紧箍咒”。而探索在总额预算管理下的多种医保支付方式的改革，则让控费这一“紧箍咒”一收再收。

面对这项“刀刃向内”的改革，浙江做好了准备吗？

“浙江是有底气的。”浙江省医疗保障局副巡视员王平洋说，“这既来自于我省全面推进县域医共体建设的经验，源于浙江在各地试点医保支付方式改革的实践，还与我省医保基金运行平稳、全省医疗信息化水平高等硬件条件密不可分。”

2017年，我省开始推进医共体建设。目前，浙江省70个县（市、区）已全面推开医共体改革，208家县级医院、1063家卫生院组建成161家医共体。这些遍布全省各地市的医共体单位，将医疗、医药、医保改革融为一体。用医保支付制度改革推动医共体服务供给侧改革，正箭在弦上。

此外，全省各地医保支付方式改革经验，为全省范围内医保支付方式改革提供着鲜活样本。记者了解到，自2017年9月开始，我省陆续启动医共体支付方式改革试点。11个试点县（市、区）大胆探索，积极创新，经过近两年的努力，取得了不少成功经验。

据了解，金华、衢州、台州先后试点DRGs点数法付费，安吉率先试点按人头包干付费，成效明显，医保基金支出增幅明显降低，看病难看病贵的矛盾进一步缓解，医院收入有所增加，具有可推广和可复制性。

今年6月28日，省委改革委审议通过了《关于推进全省县域医共体基本医疗保险支付方式改革的意见》，为全面启动医共体支付方式改革提供了“指挥棒”。

省医保局相关负责人介绍说，医保支付方式改革是推进医共体建设的重要政策工具，此次改革的核心就是放权，把医保部门的精力集中到管预算、管评价、管监督上，减少对医共体内部事务的干预，支持它们通过内部资源分配调整促进整体效益提升，调动医共体自主管理的积极性，从“要我管”变成“我要管”。

接下来，全省还将依托这一改革契机，充分释放机构改革的红利，进一步强化部门协作，加强政策协同，建立配套机制，比如推动真正做实分级诊疗制度，让老百姓在家门口就有好的医疗资源，实现就近看病，对基层首诊、双向转诊的病人给予医保政策上的优惠，不断提升人民群众获得感和安全感。

记者了解到，9月底前，省医保局会同卫生健康委制定出台DRGs分组标准和点数法付费办法，各设区市制定出台医共体支付方式改革实施细则。12月底前，卫生健康委各统筹区制定分级诊疗目录和双向转诊管理办法，确保改革落实到位。

“我们希望争取通过3年努力，全面建成医保基金预算更加合理、分类方法更加科学、协同保障更加有力、资源配置更加有效的医保支付体系，为全国医改工作提供浙江样本。”杨烨说。

【深一度】

把每分医疗费都花在刀刃上

在区域内搞预算，其实就相当于“放水养鱼”，让医院竞争，这对公立医院来讲是极大的挑战。

——清华大学就业与社会保障研究中心主任杨燕绥

在具体操作层面，不管是住院医疗服务采取DRGs点数法付费，还是门诊医疗服务探索按人头付费等支付方式改革，其大前提都是要进行“总额预算管理”，也就是“先切好蛋糕”，让有限的医保基金，通过一系列制度设计，用以调整医院、医务人员的医疗服务行为，让每一分钱都花在刀刃上。

——浙江省卫生健康委巡视员马伟杭

支付改革，正是通过理顺医院和医务人员的利益导向，把节约医保基金和增加医疗收入统一起来，促使医共体医疗机构从强化健康管理入手，真正落实好家庭医生签约服务、分级诊疗等政策，在源头上节约医保基金，推动健康关口前移，实现从保疾病转变为保健康。

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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
_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"]	/index.php/index-view-aid-12574.html
_SERVER["URL"]	/index.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"]	yyjg.net
_SERVER["SCRIPT_NAME"]	/index.php
_SERVER["SCRIPT_FILENAME"]	D:\wwwroot\yyjg.net\wwwroot\index.php
_SERVER["REQUEST_URI"]	/index.php/index-view-aid-12574.html
_SERVER["REQUEST_METHOD"]	GET
_SERVER["REMOTE_USER"]	no value
_SERVER["REMOTE_PORT"]	61812
_SERVER["REMOTE_HOST"]	216.73.216.196
_SERVER["REMOTE_ADDR"]	216.73.216.196
_SERVER["QUERY_STRING"]	no value
_SERVER["PATH_TRANSLATED"]	D:\wwwroot\yyjg.net\wwwroot\index.php\index-view-aid-12574.html
_SERVER["PATH_INFO"]	/index-view-aid-12574
_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"]	yyjg.net
_SERVER["HTTP_ACCEPT_ENCODING"]	gzip, br, zstd, deflate
_SERVER["HTTP_ACCEPT"]	/
_SERVER["HTTP_CONNECTION"]	close
_SERVER["FCGI_ROLE"]	RESPONDER
_SERVER["PHP_SELF"]	/index.php/index-view-aid-12574.html
_SERVER["REQUEST_TIME_FLOAT"]	1789636354.5405
_SERVER["REQUEST_TIME"]	1789636354

PHP Authors
Contribution	Authors
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
Contribution	Authors
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
Module	Authors
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.

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