What kind of experts are needed for the screening? Screening: what's new? Where to get a medical preventive examination

Any doctor will say that the disease is easier to prevent, and if it was not possible to do this, then you should try to start treatment at the earliest stage, preventing it from moving into a severe stage or chronic form. In order to prevent diseases and epidemics at work, the employer should pay great attention to the health of employees and regularly organize medical examinations.

Preventive medical examination, types

Medical examination of employees is a medical examination necessary to determine whether a person is fit to engage in a certain professional activity or not. Employers are interested in conducting preventive examinations of employees, because this allows them to detect those diseases that can seriously affect the entire operation of the enterprise at the initial stages. Inspections are also widely used to ensure high-quality labor potential of the enterprise, thereby increasing work efficiency. Medical examinations are divided into:

preliminary, which, in fact, are the selection of employees for medical reasons before going to work. They determine fitness for the job by the state of their health;

Periodic, necessary to identify the first signs of occupational diseases in working employees, the occurrence of which is associated with the presence of harmful factors;

Extraordinary, which are carried out if an accident has occurred at the enterprise or a mass disease has spread.

Who needs to undergo a medical examination?

Employees whose activities are associated with harmful or dangerous factors in the process of performing their work duties must undergo a mandatory medical examination. The employer is obliged to inform the employee before hiring about the presence of harmful factors in the workplace. The list of harmful or dangerous factors and works for which mandatory medical examinations are required is approved by law. In addition to employees involved in hazardous and hazardous production, medical examinations are also mandatory for employees who:

are engaged in construction production;
drive vehicles;
serve in private security;
are engaged in maintenance of electric power facilities;
work on the railway transport;
are employees of public catering, food industry and trade enterprises;
work in children's institutions (schools, studios, sports sections, kindergartens), universities, medical, treatment and preventive institutions, pharmacies;
are engaged in public services;
work in water treatment plants.

In addition, workers under the age of 18, professional athletes and office workers who spend more than half of their working time at the computer must undergo medical examinations.

What is included in the screening?

The volume of studies included in the mandatory medical examination directly depends on the presence of many factors that the employee faces. The medical examination includes the appointment of specialist doctors, fluorography, general clinical blood and urine tests, and a cardiogram. If there is a decision of the employer, then it is possible to expand the scope of the physical examination by adding studies that are most important for workers in a certain area (blood chemistry, thyroid hormones, tumor markers, etc.). A preventive appointment with a specialist doctor consists in taking an anamnesis, conducting an examination in order to identify the main violations and health problems in your profile. The list of medical specialists usually consists of:

therapist,
ophthalmologist,
otolaryngologist,
neuropathologist,
surgeon,
gynecologist for female employees.

If a pathology is detected during medical examination of employees the doctor gives recommendations and referral for further examination. This may be an ECG, ultrasound, Holter monitoring, additional tests, depending on the specialization of the doctor and the identified pathology. If you need to clarify the diagnosis, determine what additional examinations and treatment are needed, then a full consultation with a doctor is already necessary.

Fluorography is necessary to detect such a dangerous and serious disease as tuberculosis, which in the early stages has no symptoms, but is already dangerous for others who are in close contact with the sick person, because tuberculosis spreads easily. In addition, this examination makes it possible to detect lung tumors.

A general blood test makes it possible to identify many problems and changes in the body, because the blood immediately reacts to all diseases and reflects a complete picture of diseases. With the help of this analysis, it is possible to detect the presence of infections, viral or bacterial, as well as inflammatory processes. Most of the major clinics and medical centers involved in medical examinations use modern automated blood analyzers that ensure the high quality of the tests. Blood for analysis is taken from a vein using safe vacuum syringe systems.

Urinalysis reveals diseases of the kidneys and urinary system, in addition, this study helps to determine the presence of liver disease, endocrine system and suggest the presence of diabetes. This analysis is also performed using an automatic analyzer.

An electrocardiogram will give the doctor a picture of the state of the heart muscle, will identify various complications that gave the heart a sore throat, jumps in blood pressure, help detect incipient ischemia, which means a lack of oxygen for the heart, and even prevent the development of such an insidious and dangerous disease as myocardial infarction.

Preliminary medical examinations are necessary when hiring, and periodic ones throughout the entire working life of the employee, once every two years, and if the employee is not yet 21 years old, then a medical examination is mandatory for him annually. After all the results are summarized, they draw up an act of the medical board, which is introduced to the employee, and the document is usually stored in the personnel department of the enterprise.

Employer's responsibility

The Labor Inspectorate regularly conducts scheduled inspections of enterprises to identify violations of labor laws, and also checks complaints from employees. If it is revealed that the organization employs employees who have not passed the required medical examination, then the inspection has the right to fine either the organization in the amount of 30-50 thousand rubles, or the head or other official in the amount of 1 to 5 thousand. An individual entrepreneur can also be fined for the same amount. In addition, the activities of the violating organization may also be suspended for up to 90 days. In case of repeated violation, an official may be disqualified for a period of one to three years.

Modern business has increased requirements for the health of employees. In order for people to work with maximum efficiency, it is important that employees are healthy in order to increase productivity and quality of work. For employees, this is a huge advantage: they can take care of their health and detect diseases in a timely manner. It is also good for employers who employ employees who are able to perform work in a timely, good and high-quality manner.

According to the Order of the Ministry of Health and Social Development of the Russian Federation No. 302n, employees of enterprises and institutions must undergo regular medical examinations. Such a requirement helps to identify and eliminate diseases in time, which has a positive effect not only on the well-being of the employee, but also on the workflow of the entire team. It also makes it possible to protect other people in contact with the worker. Below we will consider the rules for preparing for a physical examination, and also tell you which doctors you will need to visit.

Which doctors are being examined?

Every person planning to make a physical examination should know which specialists need to be visited. The list of doctors may vary depending on the specifics of work, working conditions, sex and age of the employee. Most often, a physical examination includes an appointment with:

• therapist;
• neuropathologist;
• otolaryngologist (ENT);
• ophthalmologist;
• gynecologist (for women);
• urologist or proctologist (for men);
• surgeon
• narcologist;
• dentist.

Preparing for a physical examination with a therapist

The medical examination begins with a visit to the therapist. This multidisciplinary specialist conducts a general examination of the patient, his skin and mucous membranes, palpates some organs and lymph nodes, assesses the condition of the musculoskeletal system, listens to the lungs with a phonendoscope, measures pressure and body temperature. The results of the anamnesis are recorded in your medical book.

An examination by a therapist does not require any special preparation. All you need to do is wear comfortable clothing that won't interfere with the examination, and be prepared to talk to your doctor about your health.

Rules for preparing for a professional examination by a neurologist

If you experience recurrent or frequent headaches, migraine attacks and dizziness, trembling hands, sleep problems, seizures, you need to make an appointment with a neurologist without waiting for the scheduled physical examination. If you do not observe any malfunctions in the functioning of the nervous system, a visit to a neurologist should take place as a preventive measure once a year (during a physical examination).

An examination by a neurologist consists in taking an anamnesis, measuring blood pressure, lightly tapping the patella with a special hammer, pricking the patient's skin with special needles to determine the threshold of sensitivity, assessing coordination of movements and balance.

In order for a specialist to receive accurate information about the state of health of a person who came to him for an examination, it is necessary to give the neurologist truthful and reliable information when answering his questions. If the doctor suspects any pathologies, he can prescribe an appointment for additional examinations - for example, magnetic resonance imaging, computed tomography, electroencephalography, echoencephalography.

Before undergoing a medical examination by a neuropathologist, it is advisable to sleep well, stop drinking tonic drinks (coffee, energy drinks, tincture of Eleutherococcus or ginseng) and alcohol. Also, if you are already taking any medications (sedatives, tranquilizers, sleeping pills), be sure to tell your doctor about it.

Otolaryngologist examination: what you need to know and how to prepare?

During a visit to the ENT, an examination of the mucous membranes of the throat and nose, auricles is performed. Preparation for a professional examination at an ENT consists in carrying out hygiene procedures: before visiting a doctor, you need to brush your teeth, clear your nose of natural mucus, and gently clean your ears with a cotton swab. Also, do not gargle and rinse your nose so that the specialist can take samples for analysis.

Rules for preparing for a professional examination by an ophthalmologist

An ophthalmologist (oculist) examines the eyeballs, the mucous membrane of the eyelids and the fundus, measures eye pressure, and checks the patient's visual acuity using special tables. To prepare for the examination, it is advisable to abandon the preliminary instillation of the eyes. You will also need to bring glasses or contact lenses to your appointment if you wear them.

Preparing for a professional examination for women (visiting a gynecologist and a mammologist)

The prospect of an upcoming gynecological examination is the reason for the excitement of every second woman. This can be easily understood from a psychological point of view, because few people feel comfortable during a visit to a gynecologist. However, every woman should understand that such an examination is a guarantee of health, not only for herself, but also for her partner.

A visit to a gynecologist includes a conversation about the nature of sexual activity, the menstrual cycle, the presence or absence of pain, discharge of an unclear nature and discomfort. This is followed by an examination in the gynecological chair using sterile equipment. At the end of the examination, the doctor takes a smear for laboratory testing.

To prepare for a physical examination by a gynecologist, a woman should give up sexual intercourse and vaginal douching 2-3 days before going to the doctor. It is also worth excluding the setting of vaginal suppositories and the use of intimate hygiene products (it is better to replace the use of the latter with washing with a decoction of chamomile or just warm water).

During the physical examination, women also need to undergo a mammologist. During a visit to this doctor, a visual examination and palpation of the mammary glands is performed, the doctor asks questions about possible pain and swelling of the breast during PMS. If the mammologist suspects that the patient has a particular disease, he will advise her to undergo an ultrasound of the mammary glands or mammography.

A visit to a mammologist during a physical examination does not require prior preparation. The only thing that needs to be done is to put on comfortable underwear and refuse the dress, as it will have to be completely removed for the examination (it is better to come to the appointment in a skirt and blouse, jeans and a sweater).

Professional examination by a proctologist or urologist (for men): how to prepare?

A timely visit to the proctologist and urologist for men is as important as an appointment with a gynecologist and mammologist for women.

Examination by a proctologist consists of questioning the patient, visual examination of the anal area, and palpation of the anus. On the evening before the proctologist, it is recommended to do a cleansing enema, as well as refuse dinner. If the appointment is scheduled for the afternoon, you can have breakfast with very light foods in a small amount.

As for a professional examination by a urologist, it includes an examination by a doctor of the scrotum and penis, as well as palpation of the prostate through the anus. In addition, sampling for laboratory testing of prostatic secretions may be required.

The rules for preparing for a professional examination by a urologist are simple: 2-3 days before visiting a doctor, you must give up sexual intercourse, conduct a cleansing enema the day before and refrain from urinating for 1-1.5 hours for examination.

Preparing for a medical examination by a surgeon

A visit to the surgeon is necessary for the timely detection of injuries and pathologies. After collecting an anamnesis, the doctor performs a visual examination and palpation of certain parts of the body, an examination using percussion and a stethoscope. If he has suspicions about the presence of a disease in a patient, the surgeon can refer him to an ultrasound or x-ray.

To prepare for the examination, shower beforehand and wear comfortable clothing that can be quickly removed for the examination.

How to prepare for a dental examination?

Dental examination helps to identify and eliminate caries, pulpitis and other dental diseases in the early stages. To prepare for a physical examination, you must thoroughly brush your teeth and rinse your mouth, and then refuse to eat until the appointment with the dentist. If the check-up is scheduled for the afternoon, it is recommended that you bring a toothbrush and toothpaste with you to work to brush your teeth immediately before your appointment.

Examination by a narcologist: what you need to know to properly prepare for it?

A visit to a narcologist is an obligatory part of a medical examination for drivers, medical staff, pharmacists, pharmacists, as well as for all employees whose field of activity, one way or another, is connected with mechanisms and apparatus.

During the examination, the narcologist asks questions in order to obtain general information about the patient's state of health, living and working conditions. Next, the doctor conducts a series of tests to determine the state of the vestibular apparatus and the basic functions of the nervous system. It is also necessary to visually inspect the skin and check the veins for the presence of non-medical injections. In addition, laboratory tests of the blood may be required for the possible detection of drug particles in it.

On the eve of the examination, it is necessary to stop smoking, drinking alcohol, as well as potent medications. If you are forced to take medication to maintain a normal state of health, this must be reported to the narcologist before the examination.

What is included in the physical examination from analyzes and diagnostic procedures?

• Finger blood test.
• Venous blood analysis.
• Analysis of urine.
• Smear collection.
• Electrocardiogram.
• Fluorography.
• Mammography.

Where to pass a medical examination in St. Petersburg?

Medical examinations are carried out both in public clinics and in private clinics and medical centers. Both those and other medical institutions have their advantages. However, when contacting private centers, you can expect a more complete range of services and attention from the staff. In addition, when registering for a medical examination at a private medical institution, the patient does not have to wait long for his turn, modern equipment is used for research, and the medical examination itself takes much less time.

In "GarantMed" you can pass a medical examination in a short time, after consulting with highly qualified specialists, and get the results of a medical examination in your hands. To do this, you need to contact the administrator and choose the most suitable date for the survey.

Sobesednik.ru found out how often and for what purposes a medical examination should be carried out.

When is it necessary?

The ideal schedule is once a year, although some specialists should be visited more often - every 6 months: for example, this concerns the examination of the dentist and gynecologist. At the moment, there is a legally established procedure for the medical examination of the adult population under the CHI policy. You can get a free medical examination every 3 years - at the age of 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 57, 60, 63, 66, 69, 72, 75, 78 , 81, 84, 87, 90, 93, 96, 99 years old. In other years (once every 2 years) you can undergo a preventive examination at the clinic.

Who needs?

Actually, everyone. In fact, regular (and conscientious!) physical examinations are the only way to detect some kind of problem in the body before it “shoots” itself and loads you with trouble. In terms of health, the principle “the sooner the better” works, and it is always easier, cheaper and more preferable to prevent a disease than to treat it later. For the purpose of early detection, regular medical examinations, screenings or medical examinations are carried out.

How is it necessary?

Naturally, there will be no point in medical examination if it is done for show, and the dialogue with the doctor will be based on the principle: “Is something bothering you?” - "Not". "Well, that's fine, here's a tip for you." This situation discredits the very idea of ​​a scheduled medical examination, but, unfortunately, it has often met before, and now. The meaning of medical examination is not to miss diseases that at first do not reveal themselves in any way, and when things go far, unfortunately, they are not completely treated - these are cardiovascular diseases (ischemic heart disease, hypertension, etc.). ), various types of cancer, tuberculosis, diabetes mellitus, pathologies of the spine and joints. So, within the framework of a medical examination, at least there should be an examination itself, as well as a certain set of analyzes and studies, without which the picture will not be complete.

What do you need?

By law, for most adults, a free medical examination is carried out once every 3 years. Here's what the survey plan looks like now:

Questioning (questionnaire), examination by a therapist

Measurement of height, weight, calculation of body mass index

Pressure measurement

Determination of cholesterol and glucose levels in the blood (express method)

ECG (at the first medical examination, then - for men over 35 and women over 45)

Midwife examination, cervical smear (for women)

Fluorography

Mammography (for women over 39)

Determination of cardiovascular risk

Blood chemistry

Fecal occult blood test (after 45 years)

PSA test (men over 50)

Ultrasound of the abdominal organs (after 39 years once every 6 years)

Measurement of intraocular pressure (after 39 years)

Examination by a neurologist (after 51 years once every 6 years)

Nevertheless, a personal plan may look different - from the timing to the volume of clinical examination. Here, the wishes of the doctors you are seeing can be taken into account (for example, a gynecologist wants to see you at least once every 6 months, a mammologist and a urologist - annually, etc.), and your individual diagnoses and risks. For example, for early detection of bowel cancer after 50 years, it is recommended to do a colonoscopy every 5 years, even without special indications, however, this study is not included in the general medical examination plan and is done only as directed by a doctor. Above is only a general scheme of the survey at the expense of the state.

Blood and urine will not be tested

The simplest analysis, to which a person will be 100% sent for almost any complaint, is UAC, a complete blood count. The same goes for a general urine test. Many generally do them on their own, without waiting for a doctor's referral, and come to the first appointment already with the results. Nevertheless, from 2018, these two studies will no longer be included in the mandatory medical examination plan: the new procedure proposed by the Ministry of Health excluded them from screening as “non-informative”. The agency clarified that neither a blood test nor a urine test will be performed by default on asymptomatic citizens - those who do not have any complaints. Only the level of sugar and cholesterol will be examined using the express method, that is, right at the reception.

point-blank question

Can they be forced to work?

No. In recent years, employers have begun to send employees for screenings, but even in this case, the principle of voluntariness works. By law, if the work does not imply mandatory regular medical examinations, the authorities can only offer to undergo medical examination, providing such an opportunity - for example, by entering into an agreement with a certain medical institution. This case is again purely voluntary, and the results of medical examination, if the employee has passed it, are a medical secret.

The clinic does not have the right specialist. What to do?

If you need advice from a specific specialist, whether as part of a medical examination or not, temporarily or indefinitely, you should be referred to another medical facility where one is available.

I have DMS. Is it possible to pass a full medical examination with such insurance?

If the type of policy does not limit the number of visits to specific doctors (this sometimes happens) - for example, no more than 10 visits to a therapist per year, 5 visits to the ENT, 2 appointments with an ophthalmologist, etc. - it is quite possible to take advantage of this opportunity. The absence of restrictions in this case allows you to make a medical examination more detailed, clarify the nuances and, as a result, possibly get more complete information about what is happening to your health than with a regular scheduled medical examination as part of the CHI.

Is it possible to skip a year or more?

When, to what extent and whether to undergo medical examination at all is your own business. Even if it seems to be necessary by age, it's still up to you to decide. Medical officials are calling for medical examinations to be made mandatory for everyone, and refuseniks to be “turned off” from some free medical services, but so far this is just an idea that is contrary to current legislation.

By the way

What is a medical check?

Check-up is another name for a routine medical examination, which is used in Western healthcare and, more recently, in domestic commercial medical centers. As a rule, a check-up is completed in one day - the program is designed so that the patient does not have to go to the doctors for weeks and months. The intensity of the program can be different - the simplest ones take 3-4 hours and include an examination of 4-5 specialists (gynecologist, ophthalmologist, urologist, therapist, dentist), 1-2 ultrasounds (usually gynecological and abdominal), several tests (for example , CBC, pap test for women, and Pap test to rule out cervical cancer) and a few other tests. A large check-in program can take a couple of days and even include options such as a full-body MRI. The price also depends on saturation.

Conducting a preventive medical examination is aimed at early detection of certain chronic non-communicable diseases (conditions) that are the main cause of disability and premature death of the population of the Russian Federation (hereinafter referred to as chronic non-communicable diseases), risk factors for their development (high blood pressure, dyslipidemia, elevated blood glucose levels). blood, tobacco smoking, harmful alcohol consumption, unhealthy diet, physical inactivity, overweight or obesity), as well as the use of narcotic drugs and psychotropic substances without a doctor's prescription.

3. Preventive medical examination is carried out once every 2 years.

In the year of the medical examination, a preventive medical examination is not carried out.

Employees engaged in work with harmful and (or) dangerous production factors, and employees engaged in certain types of work, who, in accordance with the legislation of the Russian Federation, undergo mandatory periodic medical examinations, are not subject to preventive medical examinations.

4. Preventive medical examination of the adult population is carried out by medical organizations (other organizations engaged in medical activities) (hereinafter referred to as the medical organization), regardless of the organizational and legal form, participating in the implementation of the program of state guarantees of free provision of medical care to citizens and the territorial program of state guarantees of free provision of citizens medical care in terms of providing primary health care, with a license to carry out medical activities, providing for work (services) on "preventive medical examinations", "therapy", "radiology", "clinical laboratory diagnostics" ("laboratory diagnostics") .

If the medical organization carrying out preventive medical examination does not have a license for medical activities for certain types of work (services) necessary to conduct a preventive medical examination in full, the medical organization concludes an agreement with another medical organization that has a license for the required types of work ( services), on the involvement of relevant medical workers in the conduct of preventive medical examinations.

5. A citizen undergoes a preventive medical examination in a medical organization in which he receives primary health care.

6. A preventive medical examination is carried out with the informed voluntary consent of a citizen or his legal representative (in relation to a person recognized as legally incompetent, if such a person, due to his condition, is not able to give consent to medical intervention), given in the form and in the manner which are approved by the Ministry of Health of the Russian Federation.

A citizen has the right to refuse to conduct a preventive medical examination in general or from certain types of medical interventions included in a preventive medical examination, in the manner and in the form approved by the Ministry of Health of the Russian Federation.

7. The head of a medical organization organizes preventive medical examinations of the population receiving medical care in a medical organization.

Therapist (district general practitioner, general practitioner of the workshop medical section, general practitioner (family doctor)) (hereinafter referred to as the general practitioner) organizes preventive medical examinations of the population of the therapeutic, including the workshop, section (general practitioner section (family doctor)), serviced territory (hereinafter referred to as the site).

The paramedic of the feldsher's health center or the feldsher's obstetric station organizes preventive medical examinations of the population of the feldsher's section in the event that he is assigned certain functions of the attending physician for the direct provision of medical care to the patient during the period of observation and his treatment, including the conduct of a preventive medical examination, in order established by order of the Ministry of Health and Social Development of the Russian Federation of March 23, 2012 N 252n "On approval of the procedure for assigning a paramedic, a midwife to the head of a medical organization when organizing the provision of primary health care and emergency medical care of certain functions of the attending physician for the direct provision medical care to the patient during the period of observation and treatment, including the prescription and use of drugs, including narcotic drugs and psychotropic drugs" (registered Tried by the Ministry of Justice of the Russian Federation on April 28, 2012, registration N 23971).

8. The main tasks of the general practitioner during preventive medical examinations are:

1) involving the population of the site in undergoing a preventive medical examination, informing about its goals and objectives, the scope of the examination and the work schedule of the units of the medical organization involved in conducting preventive medical examinations, the necessary preparatory measures, as well as increasing the motivation of citizens to undergo a preventive medical examination, including by conducting explanatory conversations at the level of a family, an organized team;

2) conducting a final medical examination of a citizen, establishing a diagnosis of a disease (condition), determining a group of a state of health, a group for dispensary observation (with a general practitioner or doctor (paramedic) of the medical prevention office), prescribing the necessary treatment, if there are medical indications, referral to additional diagnostic studies that are not included in the scope of a preventive medical examination, or to receive specialized, including high-tech, medical care, for sanatorium treatment;

3) conducting brief preventive counseling, referral of citizens with identified risk factors for the development of chronic non-communicable diseases to the department (office) of medical prevention or a health center to provide medical care to correct these risk factors;

4) participation in the preparation (maintenance) of accounting and reporting medical documentation, including a health passport, the form of which is approved by the Ministry of Health of the Russian Federation (hereinafter referred to as the health passport);

5) summing up the results of preventive medical examinations.

9. The main tasks of the department (office) of medical prevention of a medical organization, including those that are part of the health center, when conducting preventive medical examinations are:

1) participation in informing the population receiving medical care in a medical organization about preventive medical examinations, their goals and objectives, as well as in conducting explanatory work and motivating citizens to undergo preventive medical examinations;

2) instructing citizens who arrived for a preventive medical examination on the procedure for passing it, the volume and sequence of the examination;

3) performing pre-hospital medical examinations (survey (questionnaire) in order to identify chronic non-communicable diseases, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor's prescription, anthropometry, calculation of body mass index, measurement of blood pressure, determination of total cholesterol and blood blood glucose by express method);

4) determination of risk factors for chronic non-communicable diseases based on the diagnostic criteria provided for in the Appendix to this Procedure;

5) formation of a set of documents, including filling out the registration form "Route card for clinical examination (preventive medical examination)", approved by the Ministry of Health of the Russian Federation (hereinafter referred to as the route card), based on the results of studies conducted as part of a preventive medical examination, to refer the patient to the final examination therapist;

6) registration of citizens who have undergone a preventive medical examination.

7) explaining to a citizen with a high risk of developing a life-threatening disease (condition) or its complication, as well as to persons living together with him, the rules of action for their development, including the timely call of an ambulance team;

8) filling in the passport part and, in agreement with the general practitioner, other sections of the health passport.

10. Preventive medical examination includes:

1) a survey (questionnaire) in order to identify chronic non-communicable diseases, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor's prescription;

2) anthropometry (measurement of standing height, body weight, waist circumference), calculation of body mass index;

3) measurement of blood pressure;

4) determination of the level of total cholesterol in the blood by the express method (laboratory method is allowed);

5) examination of the level of glucose in the blood by the express method (laboratory method is allowed);

6) determination of the total cardiovascular risk (for citizens under the age of 65);

8) mammography (for women aged 39 and older);

9) a clinical blood test (the minimum scope of the study includes: determination of the concentration of hemoglobin in erythrocytes, the number of leukocytes and the erythrocyte sedimentation rate);

10) examination of feces for occult blood (for citizens aged 45 years and older);

11) reception (examination) of a general practitioner, including the determination of a group of health status, a dispensary observation group (by a general practitioner or a doctor (paramedic) of the medical prevention office), brief preventive counseling, if there are medical indications, referral of citizens to receive a specialized, including high-tech, medical care, sanatorium treatment.

11. If a citizen has the results of the studies specified in paragraph 10 of this Procedure, which were carried out within 12 months preceding the month of the preventive medical examination, the decision on the need for re-examination as part of the preventive medical examination is made individually, taking into account all the available results of the examination and the condition citizen's health.

12. If a citizen, during a preventive medical examination, has medical indications for conducting research and examinations by medical specialists that are not included in the scope of a preventive medical examination in accordance with this Procedure, they are assigned and performed to the citizen, taking into account the provisions of the procedures for providing medical care according to the profile of the identified or the alleged disease (condition) and standards of medical care approved by the Ministry of Health of the Russian Federation.

13. The results of the examination by the general practitioner and the studies carried out during the preventive medical examination are entered into the route card, which is filed into the accounting form N 025 / y-04 "Medical card of the outpatient", approved by order of the Ministry of Health and Social Development of the Russian Federation dated November 22 2004 N 255 (registered by the Ministry of Justice of the Russian Federation on December 14, 2004, registration N 6188) (hereinafter referred to as the outpatient medical record).

14. On the basis of information about the passage of a preventive medical examination by a citizen, a medical worker of the department (office) of medical prevention fills out a "Card for the registration of medical examinations (preventive medical examinations)" in the form approved by the Ministry of Health of the Russian Federation.

Information about the preventive medical examination and its results are entered by the general practitioner in the health passport, which is issued to the citizen.

15. The following criteria are used to determine, based on the results of a preventive medical examination, the group of the state of health of a citizen and plan the tactics of his medical supervision:

I group of health status- citizens who do not have chronic non-communicable diseases, do not have risk factors for the development of such diseases or have these risk factors with low or medium total cardiovascular risk and who do not need dispensary observation for other diseases (conditions).

Such citizens are provided with brief preventive counseling, correction of risk factors for the development of chronic non-communicable diseases by a general practitioner, a medical worker of the department (office) of medical prevention or a health center.

II group of health status- citizens who have not been diagnosed with chronic non-communicable diseases, have risk factors for the development of such diseases with a high or very high total cardiovascular risk and who do not need dispensary observation for other diseases (conditions).

Such citizens undergo correction of risk factors for the development of chronic non-communicable diseases in the department (office) of medical prevention or a health center, if there are medical indications, the general practitioner prescribes drugs for medical use in order to pharmacologically correct these risk factors. These citizens are subject to dispensary observation by a doctor (paramedic) of the department (office) of medical prevention.

III group of health status- citizens with diseases (conditions) requiring the establishment of dispensary observation or the provision of specialized, including high-tech, medical care, as well as citizens suspected of having these diseases (conditions) who need additional examination ***.

Such citizens are subject to dispensary observation by a general practitioner, medical specialists with medical, rehabilitation and preventive measures. Citizens with risk factors for the development of chronic non-communicable diseases are corrected in the department (office) of medical prevention or a health center.

16. The medical organization keeps a record of citizens who have undergone a preventive medical examination, with registration of studies performed during the preventive medical examination, and studies performed earlier outside the framework of the preventive medical examination (within 12 months preceding the month of the preventive medical examination) and taken into account during a preventive medical examination, as well as refusals of citizens to undergo individual studies.

17. A preventive medical examination is considered completed if at least 85% of the scope of the examination established for a given age and gender of a citizen is completed (taking into account studies performed earlier outside the framework of a preventive medical examination (within 12 months preceding the month of the preventive medical examination) and refusals of a citizen from passing individual studies).

______________________________

* Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation".

** Fluorography of the lungs is not performed if a citizen during the previous calendar year or the year of the preventive medical examination underwent radiography (fluoroscopy) or computed tomography of the chest organs.

*** Based on the results of an additional examination, the citizen's health status group may be changed.

PREVENTIVE INSPECTION
AND DISPENSERIZATION OF CERTAIN GROUPS OF THE ADULTS POPULATION

The procedure for conducting a preventive medical examination and medical examination of certain groups of the adult population is determined by Order of the Ministry of Health of Russia dated March 13, 2019 N 124n "On approval of the procedure for conducting a preventive medical examination and medical examination of certain groups of the adult population."

This procedure regulates issues related to the conduct of preventive medical examinations and medical examinations in medical organizations of the following groups of the adult population (aged 18 years and older):

1) working citizens;

2) non-working citizens;

This procedure does not apply in cases where legislative and other regulatory legal acts of the Russian Federation establish a different procedure for conducting a preventive medical examination or medical examination of certain categories of citizens.

Preventive medical examination and clinical examination are carried out within the framework of the program of state guarantees of free provision of medical care to citizens and the territorial program of state guarantees of free provision of medical care to citizens.

The executive authorities of the constituent entities of the Russian Federation in the field of health care ensure that citizens undergo preventive medical examinations, clinical examinations, including in the evenings and Saturdays, and also provide citizens with the opportunity to remotely book appointments (examinations, consultations) with medical workers, research and other medical interventions carried out as part of preventive medical examinations and medical examinations.

A citizen undergoes a preventive medical examination and medical examination in a medical organization in which he receives primary health care.

A necessary precondition for a preventive medical examination and clinical examination is the giving of an informed voluntary consent of a citizen (his legal representative) to medical intervention in compliance with the requirements established by Article 20 of Federal Law N 323-FZ.

A citizen has the right to refuse to conduct a preventive medical examination and (or) medical examination in general or from certain types of medical interventions included in the scope of a preventive medical examination and (or) medical examination.

DISPENSERIZATION OF CERTAIN GROUPS OF THE ADULTS POPULATION

What is dispensary?

Medical examination is a set of measures that includes a preventive medical examination and additional methods of examinations conducted to assess the state of health (including determining the health group and the dispensary observation group) and carried out in relation to certain groups of the population in accordance with the legislation of the Russian Federation.

Medical examination is carried out is free under the OMS policy.

The list of studies and examinations performed by doctors or a paramedic / midwife during medical examinations varies depending on the age and gender of the citizen.

The dispensary is carried out in two stages.

In order to pass the first stage of the survey as quickly and efficiently as possible, you must follow simple rules:

Come to the clinic in the morning;

Before testing, you must not eat anything, give up smoking, alcohol and playing sports.

Why do you need to undergo a medical examination?

Medical examination of the adult population is carried out through an in-depth examination of the health status of citizens in order to:

1) prevention and early detection (screening) of chronic non-communicable diseases (conditions) that are the main cause of disability and premature death of the population of the Russian Federation, risk factors for their development, including high blood pressure, hypercholesterolemia, high fasting blood glucose, tobacco smoking, the risk of harmful alcohol consumption, poor nutrition, low physical activity, overweight or obesity, as well as the risk of using narcotic drugs and psychotropic substances without a doctor's prescription;

2) determination of the health group, necessary preventive, therapeutic, rehabilitation and recreational activities for citizens with identified chronic non-communicable diseases and (or) risk factors for their development, as well as for healthy citizens;

3) conducting preventive counseling of citizens with identified chronic non-communicable diseases and risk factors for their development;

4) determination of a group for dispensary observation of citizens with identified chronic non-communicable diseases and other diseases (conditions), including citizens with high and very high cardiovascular risk.

Regular medical examinations are necessary, regardless of how you feel. Even if a person considers himself healthy, during the medical examination, chronic non-communicable diseases are often found in him, the treatment of which is most effective at an early stage.

Clinical examination will allow to maintain and strengthen health, and, if necessary, conduct additional examination and treatment in a timely manner. Doctors' consultations and test results will help you not only learn about your health, but also get the necessary recommendations about the basics of a healthy lifestyle or identified risk factors.

Who can get screened?

Since 2013, the following groups of the adult population have been undergoing medical examinations:

working citizens;

non-working citizens;

Students in educational institutions full-time.

How often is screening done?

The examination is carried out:

1) once every three years at the age of 18 to 39 inclusive;

2) annually at the age of 40 and older, as well as in relation to certain categories of citizens, including:

a) disabled veterans of the Great Patriotic War and combat invalids, as well as participants in the Great Patriotic War who became disabled due to a general illness, labor injury or other reasons (except for persons whose disability was due to their unlawful actions);

b) persons awarded the badge "Inhabitant of besieged Leningrad" and recognized as disabled due to a general illness, labor injury and other reasons (except for persons whose disability occurred as a result of their unlawful actions);

c) former juvenile prisoners of concentration camps, ghettos, other places of detention created by the Nazis and their allies during the Second World War, recognized as disabled due to a general illness, labor injury and other reasons (with the exception of persons whose disability occurred as a result of their illegal actions);

d) working citizens who have not reached the age that gives the right to receive an old-age pension, including ahead of schedule, within five years before the onset of such an age, and working citizens who are recipients of an old-age pension or a service pension.

Where can you get a medical examination?

Citizens undergo a medical examination in a medical organization at the place of residence (attachment), in which they receive primary health care (in a polyclinic, in a center (department) of general medical practice (family medicine), in a medical outpatient clinic, medical unit, etc.). Each person who would like to undergo a medical examination should contact their local therapist.

How to get a medical examination for a working person?

According to Article 185.1 of the Labor Code of the Russian Federation, since 2019, employees, when undergoing a medical examination in the manner prescribed by legislation in the field of health protection, have the right to be released from work for one working day once every three years, while retaining their place of work (position) and average earnings .

Employees who have not reached the age giving the right to receive an old-age pension, including early, within five years before the onset of such age, and employees who are recipients of an old-age pension or a superannuation pension, when undergoing medical examination in the manner prescribed by law in in the field of health protection, have the right to be released from work for two working days once a year, while retaining their place of work (position) and average earnings.

The employee is released from work to undergo medical examination on the basis of his written application, while the day (days) of release from work is (are) agreed upon with the employer.

What documents are required for medical examination?

Each citizen going for a medical examination must have a passport and a compulsory medical insurance policy.

If you underwent medical examinations in the current or previous year, take the documents confirming this and show them to medical workers before starting the medical examination.

What diagnostic studies are carried out as part of the clinical examination at the first stage?

The first stage of medical examination (screening) is carried out in order to identify in citizens signs of chronic non-communicable diseases, risk factors for their development, the risk of harmful alcohol consumption, the use of narcotic drugs and psychotropic substances without a doctor's prescription, determining the health group, as well as determining medical indications for additional examinations. and examinations by specialist doctors to clarify the diagnosis of the disease (condition) at the second stage of clinical examination and includes:

1. for citizens aged 18 to 39 inclusive once every 3 years:

10) examination by a paramedic (midwife) or obstetrician-gynecologist of women aged 18 to 39 years once a year;

1) screening for the detection of malignant neoplasms of the cervix (in women): at the age of 18 to 64 years inclusive - taking a smear from the cervix, a cytological examination of a smear from the cervix 1 time in 3 years;

2) examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes;

c) conducting a brief individual preventive counseling in the department (office) of medical prevention (health center) by a general practitioner;

d) admission (examination) by a general practitioner based on the results of the first stage of clinical examination, including an examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes, in order to establish a diagnosis , determining the health group, dispensary observation group, determining medical indications for examinations (consultations) and examinations as part of the second stage of clinical examination;

2. for citizens aged 40 to 64 inclusive once a year

a) carrying out a preventive medical examination in the amount of:

1) questioning of citizens aged 18 years and older once a year in order to:

Collecting anamnesis, identifying aggravated heredity, complaints, symptoms characteristic of the following non-communicable diseases and conditions: angina pectoris, transient ischemic attack or acute cerebrovascular accident, chronic obstructive pulmonary disease, diseases of the gastrointestinal tract;

Determination of risk factors and other pathological conditions and diseases that increase the likelihood of developing chronic non-communicable diseases: smoking, the risk of harmful alcohol consumption, the risk of using narcotic drugs and psychotropic substances without a doctor's prescription, diet, physical activity;

2) calculation based on anthropometry (measurement of height, body weight, waist circumference) of the body mass index, for citizens aged 18 years and older, once a year;

3) measurement of blood pressure in the peripheral arteries for citizens aged 18 years and older once a year;

4) study of the level of total cholesterol in the blood (using the express method is allowed) for citizens aged 18 years and older once a year;

5) determination of the level of glucose in the blood on an empty stomach (using the express method is allowed) for citizens aged 18 years and older once a year;

7) fluorography of the lungs or radiography of the lungs for citizens aged 18 years and older 1 time in 2 years;

8) electrocardiography at rest during the first passage of a preventive medical examination, then at the age of 35 years and older once a year;

9) measurement of intraocular pressure during the first passage of a preventive medical examination, then at the age of 40 years and older once a year;

b) carrying out screening activities aimed at early detection of oncological diseases:

1) screening for the detection of malignant neoplasms of the cervix (in women): at the age of 18 years and older - examination by a paramedic (midwife) or obstetrician-gynecologist once a year; at the age of 18 to 64 years inclusive - taking a smear from the cervix, a cytological examination of a smear from the cervix 1 time in 3 years;

3) screening for the detection of malignant neoplasms of the prostate gland (in men): at the age of 45, 50, 55, 60 and 64 years - determination of prostate-specific antigen in the blood;

4) screening for the detection of malignant neoplasms of the large intestine and rectum: at the age of 40 to 64 years inclusive - examination of feces for occult blood by an immunochemical qualitative or quantitative method once every 2 years;

5) examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes;

6) screening for the detection of malignant neoplasms of the esophagus, stomach and duodenum: at the age of 45 - esophagogastroduodenoscopy (if necessary, it can be carried out with the use of anesthesia, including in medical organizations providing specialized medical care, in a day hospital).

d) conducting a brief individual preventive counseling in the department (office) of medical prevention (health center);

e) reception (examination) by a general practitioner based on the results of the first stage of medical examination, including an examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes, in order to establish a diagnosis , determining the health group, dispensary observation group, determining medical indications for examinations (consultations) and examinations as part of the second stage of clinical examination;

3. for citizens aged 65 and over once a year(with the exception of appointments (examinations), medical examinations and other medical interventions included in the scope of the first stage of clinical examination, with a different frequency):

a) carrying out a preventive medical examination in the amount of:

1) questioning of citizens aged 18 years and older once a year in order to:

Collecting anamnesis, identifying aggravated heredity, complaints, symptoms characteristic of the following non-communicable diseases and conditions: angina pectoris, transient ischemic attack or acute cerebrovascular accident, chronic obstructive pulmonary disease, diseases of the gastrointestinal tract;

Determination of risk factors and other pathological conditions and diseases that increase the likelihood of developing chronic non-communicable diseases: smoking, the risk of harmful alcohol consumption, the risk of using narcotic drugs and psychotropic substances without a doctor's prescription, diet, physical activity;

2) calculation based on anthropometry (measurement of height, body weight, waist circumference) of the body mass index, for citizens aged 18 years and older, once a year;

3) measurement of blood pressure in the peripheral arteries for citizens aged 18 years and older once a year;

4) study of the level of total cholesterol in the blood (using the express method is allowed) for citizens aged 18 years and older once a year;

5) determination of the level of glucose in the blood on an empty stomach (using the express method is allowed) for citizens aged 18 years and older once a year;

6) determination of absolute cardiovascular risk in citizens aged 40 to 64 inclusive once a year;

7) fluorography of the lungs or radiography of the lungs for citizens aged 18 years and older 1 time in 2 years;

8) electrocardiography at rest during the first passage of a preventive medical examination, then at the age of 35 years and older once a year;

9) measurement of intraocular pressure during the first passage of a preventive medical examination, then at the age of 40 years and older once a year;

b) carrying out screening activities aimed at early detection of oncological diseases:

1) screening for the detection of malignant neoplasms of the cervix (in women): at the age of 18 years and older - examination by a paramedic (midwife) or obstetrician-gynecologist once a year;

2) screening for the detection of malignant neoplasms of the mammary glands (in women): at the age of 40 to 75 years inclusive - mammography of both mammary glands in two projections with double reading of radiographs 1 time in 2 years;

3) screening for the detection of malignant neoplasms of the large intestine and rectum: at the age of 65 to 75 years inclusive - examination of feces for occult blood by immunochemical qualitative or quantitative method once a year;

4) examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes;

c) complete blood count (hemoglobin, leukocytes, ESR);

d) conducting brief individual preventive counseling in the department (office) of medical prevention (health center);

e) reception (examination) by a general practitioner based on the results of the first stage of medical examination, including an examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes, in order to establish a diagnosis , determining the health group, dispensary observation group, determining medical indications for examinations (consultations) and examinations as part of the second stage of clinical examination.

Based on the results of the first stage, the therapist determines the health group and decides whether a more detailed examination is necessary (referral to the second stage of medical examination).

What diagnostic studies are carried out as part of the clinical examination at the second stage?

The second stage of clinical examination is carried out for the purpose of additional examination and clarification of the diagnosis of the disease (condition) and includes:

1) examination (consultation) by a neurologist (in the presence of newly identified indications or suspicions of a previously suffered acute cerebrovascular accident for citizens who are not under dispensary observation on this occasion, as well as in cases of identifying violations of motor function, cognitive impairment based on the results of the questionnaire and suspicions of depression in citizens aged 65 years and older who are not under dispensary observation on this occasion);

2) duplex scanning of the brachycephalic arteries (for men aged 45 to 72 years inclusive and women aged 54 to 72 years inclusive in the presence of a combination of three risk factors for the development of chronic non-communicable diseases: high blood pressure, hypercholesterolemia, overweight or obesity , as well as in the direction of a neurologist with a first identified indication or suspicion of a previously suffered acute cerebrovascular accident for citizens aged 65 to 90 years who are not under dispensary observation on this occasion);

3) examination (consultation) by a surgeon or urologist (for men aged 45, 50, 55, 60 and 64 years with an increase in the level of prostate-specific antigen in the blood of more than 4 ng / ml);

4) examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (for citizens aged 40 to 75 years inclusive with identified pathological changes based on the results of screening for the detection of malignant neoplasms of the large intestine and rectum, with aggravated heredity by family adenomatosis and (or) malignant neoplasms of the large intestine and rectum, if other medical indications are identified based on the results of the questionnaire, as well as by appointment of a general practitioner, urologist, obstetrician-gynecologist in cases of detection of symptoms of malignant neoplasms of the large intestine and rectum );

5) colonoscopy (for citizens in case of suspicion of malignant neoplasms of the large intestine as prescribed by a surgeon or coloproctologist);

6) esophagogastroduodenoscopy (for citizens in case of suspicion of malignant neoplasms of the esophagus, stomach and duodenum as prescribed by a general practitioner);

7) radiography of the lungs, computed tomography of the lungs (for citizens in case of suspicion of malignant neoplasms of the lung as prescribed by a general practitioner);

8) spirometry (for citizens with suspected chronic bronchopulmonary disease, smoking citizens, identified by the results of the questionnaire, - as prescribed by a general practitioner);

9) examination (consultation) by an obstetrician-gynecologist (for women aged 18 years and older with identified pathological changes based on the results of screening for the detection of malignant neoplasms of the cervix, aged 40 to 75 years with identified pathological changes based on the results of screening activities, aimed at early detection of malignant neoplasms of the mammary glands);

10) examination (consultation) by an otorhinolaryngologist (for citizens aged 65 years and older in the presence of medical indications based on the results of a questionnaire or appointment (examination) of a general practitioner);

11) examination (consultation) by an ophthalmologist (for citizens aged 40 years and older with increased intraocular pressure, and for citizens aged 65 years and older who have a decrease in visual acuity that is not amenable to spectacle correction, identified by the results of a questionnaire);

12) conducting individual or group (school for patients) in-depth preventive counseling in the department (office) of medical prevention (health center) for citizens:

a) with diagnosed coronary heart disease, cerebrovascular diseases, chronic ischemia of the lower extremities of atherosclerotic origin or diseases characterized by high blood pressure;

b) with the risk of harmful consumption of alcohol and (or) consumption of narcotic drugs and psychotropic substances identified by the results of the questionnaire without a doctor's prescription;

c) for all citizens aged 65 years and older in order to correct identified risk factors and (or) prevent senile asthenia;

d) when a high relative, high and very high absolute cardiovascular risk, and (or) obesity, and (or) hypercholesterolemia with a total cholesterol level of 8 mmol / l or more, as well as smoking more than 20 cigarettes in day, the risk of harmful alcohol consumption and (or) the risk of non-medical use of narcotic drugs and psychotropic substances;

13) reception (examination) by a general practitioner based on the results of the second stage of medical examination, including the establishment (clarification) of a diagnosis, the determination (clarification) of a health group, the determination of a group for dispensary observation (taking into account the conclusions of medical specialists), the direction of citizens in the presence of medical indications for additional an examination not included in the scope of medical examination, including a referral for an examination (consultation) by an oncologist in case of suspected oncological diseases in accordance with the Procedure for providing medical care to the population in the field of oncology, approved by order of the Ministry of Health of Russia dated November 15, 2012 N 915n, as well as to receive specialized, including high-tech, medical care, for sanatorium treatment.

If a citizen in the process of medical examination reveals medical indications for examinations (consultations) by specialist doctors, studies and events, including an examination (consultation) by an oncologist in case of suspicion of oncological diseases of visual and other localizations that are not included in the scope of medical examination in accordance with by this procedure, they are appointed and performed in accordance with the provisions of the procedures for the provision of medical care according to the profile of the identified or suspected disease (condition), taking into account the standards of medical care, as well as on the basis of clinical recommendations.

The result of medical examination

According to the questionnaire, the results of laboratory tests and screening studies, the therapist determines the patient's health group.

To determine, based on the results of a preventive medical examination or clinical examination, a citizen’s health group and a dispensary observation group, the following criteria are used:

I health group- citizens who do not have chronic non-communicable diseases, do not have risk factors for the development of such diseases or have these risk factors at low or medium absolute cardiovascular risk and who do not need dispensary observation for other diseases (conditions);

II health group- citizens who have not established chronic non-communicable diseases, but have risk factors for the development of such diseases at high or very high absolute cardiovascular risk, as well as citizens who have obesity and (or) hypercholesterolemia with a total cholesterol level of 8 mmol / l and (or) persons who smoke more than 20 cigarettes per day, and (or) persons with an identified risk of harmful alcohol consumption and (or) the risk of using narcotic drugs and psychotropic substances without a doctor's prescription, and who do not need dispensary observation for about other diseases (conditions).

Citizens with health group II with a high or very high absolute cardiovascular risk are subject to dispensary observation by a doctor (paramedic) of the department (office) of medical prevention or a health center, as well as by a paramedic of a medical assistant's health center or a feldsher-obstetric station, with the exception of patients with a level of total cholesterol 8 mmol / l and more, which are subject to dispensary observation by a general practitioner. Citizens with group II health, if there are medical indications, are prescribed medicines for medical use for the purpose of pharmacological correction of identified risk factors;

IIIa health group- citizens with chronic non-communicable diseases requiring the establishment of dispensary observation or the provision of specialized, including high-tech, medical care, as well as citizens suspected of having these diseases (conditions) who need additional examination;

IIIb health group- citizens who do not have chronic non-communicable diseases, but require the establishment of dispensary observation or the provision of specialized, including high-tech, medical care for other diseases, as well as citizens suspected of having these diseases who need additional examination.

Citizens with IIIa and IIIb health groups are subject to dispensary observation by a general practitioner, medical specialists with preventive, therapeutic and rehabilitation measures.

Regular medical examinations will allow you to significantly reduce the likelihood of developing the most dangerous diseases, which are the main cause of disability and premature death of the population, or to identify them at an early stage of development, when their treatment is most effective. But medicine is powerless without an initiative about one's own health.

PREVENTIVE MEDICAL EXAMINATION

A medical examination is a complex of medical interventions aimed at identifying pathological conditions, diseases and risk factors.

A preventive medical examination is carried out for the purpose of early (timely) detection of conditions, diseases and risk factors for their development, non-medical use of narcotic drugs and psychotropic substances, as well as in order to determine health groups and develop recommendations for patients.

In 2019, preventive examination received the same status as medical examination. It can be called "abbreviated medical examination" or its lightweight version.

How often is a preventive medical examination carried out?

Preventive medical examination is carried out annually:

1) as an independent event;

2) within the framework of medical examination;

3) within the framework of dispensary observation (during the first dispensary appointment (examination, consultation) in the current year).

Who can get a preventive medical examination?

Preventive medical examination of the adult population is carried out from the age of 18.

Preventive medical examinations are subject to:

1) working citizens;

2) non-working citizens;

3) students in educational institutions full-time.

Where can I get a preventive medical examination?

A citizen undergoes a preventive medical examination in a medical organization in which he receives primary health care.

Your district doctor (paramedic) or district nurse or receptionist will tell you in detail where, when and how you can undergo a preventive medical examination, agree with you on the approximate date (period) of its passage.

How long does a preventive medical examination take?

A preventive medical examination usually requires two visits. The first visit takes approximately 2-3 hours. The second visit in 1-2 days (depending on the length of time required for the results of your research to reach the doctor) to the local doctor takes about 1 hour.

If, according to the results of a preventive medical examination, you are suspected of having a chronic non-communicable disease or a high or very high total cardiovascular risk, the local doctor informs you about this and sends you for additional examination or in-depth preventive counseling.

Preventive medical examination includes:

1) questioning of citizens aged 18 years and older once a year in order to:

Collecting anamnesis, identifying aggravated heredity, complaints, symptoms characteristic of the following non-communicable diseases and conditions: angina pectoris, transient ischemic attack or acute cerebrovascular accident, chronic obstructive pulmonary disease, diseases of the gastrointestinal tract;

Determination of risk factors and other pathological conditions and diseases that increase the likelihood of developing chronic non-communicable diseases: smoking, the risk of harmful alcohol consumption, the risk of using narcotic drugs and psychotropic substances without a doctor's prescription, diet, physical activity;

Identification in citizens aged 65 years and older of the risk of falls, complaints characteristic of osteoporosis, depression, heart failure, uncorrected hearing and vision impairments;

2) calculation based on anthropometry (measurement of height, body weight, waist circumference) of the body mass index, for citizens aged 18 years and older, once a year;

3) measurement of blood pressure in the peripheral arteries for citizens aged 18 years and older once a year;

4) study of the level of total cholesterol in the blood (using the express method is allowed) for citizens aged 18 years and older once a year;

5) determination of the level of glucose in the blood on an empty stomach (using the express method is allowed) for citizens aged 18 years and older once a year;

6) determination of the relative cardiovascular risk in citizens aged 18 to 39 years inclusive, once a year;

7) determination of absolute cardiovascular risk in citizens aged 40 to 64 inclusive once a year;

8) fluorography of the lungs or radiography of the lungs for citizens aged 18 years and older, once every 2 years;

9) electrocardiography at rest during the first preventive medical examination, then at the age of 35 years and older once a year;

10) measurement of intraocular pressure at the first passage of a preventive medical examination, then at the age of 40 years and older once a year;

11) examination by a paramedic (midwife) or obstetrician-gynecologist of women aged 18 to 39 years once a year;

12) admission (examination) based on the results of a preventive medical examination, including an examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes, by a paramedic of a paramedical health center or feldsher-obstetric point, a general practitioner or a doctor for medical prevention of the department (office) of medical prevention or a health center.

If a citizen in the course of a preventive medical examination reveals medical indications for examinations (consultations) by specialist doctors, studies and activities, including an examination (consultation) by an oncologist in case of suspicion of oncological diseases of visual and other localizations that are not included in the scope of preventive medical examination in accordance with this procedure, they are appointed and performed in accordance with the provisions of the procedures for the provision of medical care for the profile of the identified or suspected disease (condition), taking into account the standards of medical care, as well as on the basis of clinical recommendations.

If a citizen is identified by the results of a preventive medical examination of a high relative, high and very high absolute cardiovascular risk, and (or) obesity, and (or) hypercholesterolemia with a total cholesterol level of 8 mmol / l or more, as well as establishing by the results of a questionnaire smoking more than 20 cigarettes a day, the risk of harmful alcohol consumption and (or) the risk of using narcotic drugs and psychotropic substances without a doctor's prescription, a citizen is referred for in-depth preventive counseling outside the framework of a preventive medical examination.

Regular medical examinations and preventive medical examinations will allow you to significantly reduce the likelihood of developing the most dangerous diseases that are the main cause of disability and mortality in our country, or to identify them at an early stage of development, when their treatment is most effective. But medicine is powerless without an initiative about one's own health.

List of medical organizations involved in preventive medical examinations and medical examinations in the territory of the Chuvash Republic in 2019