Clinical examination born in 1984. What is prophylactic medical examination. What does it include

Features of the first stage

On January 1, 2018, a new procedure for conducting clinical examination of certain groups of the adult population of Russia came into force, approved by the order of the Ministry of Health of the Russian Federation. In general, the task of the next stage of large-scale monitoring of the health of Russians, as well as of the past, is the early detection of current diseases (at the very beginning of their development) and chronic pathologies. According to the organizers of the process, "such an annual control helps to detect the most common health problems in different age groups, and as a result, to reduce the mortality rate of Russians, especially at a young age." And citizens of our country over the age of 21 must also undergo such scheduled examinations. But the list of medical services has changed.

So, what's new in the medical examination-2018 awaiting those who have the legal right to pass it for free this year? Who is entitled to what? What should a Russian have with him when going to a medical examination? And what can he demand from doctors?

Regardless of the state of health ...

Regular medical examination is necessary for all people, regardless of their state of health, - says Sergey BOYTSOV, chief freelance specialist in preventive medicine of the Ministry of Health of Russia. - Even if a person considers himself healthy, during the clinical examination he often has dangerous non-infectious diseases, the treatment of which is most effective for early stage... The state provides for such a concern for the health of the population in the form of medical examination: tests, examination on equipment, consultations. This will help prevent or detect illnesses, adjust lifestyle choices, or initiate treatment to prevent further illness. And all this is at the expense of the state, according to the compulsory medical insurance policy. The same surveys in paid medical centers man will fly, as they say, a pretty penny, and not one.

And indeed it is. Although almost every third of the Russians surveyed thinks that “clinical examination is often carried out formally and does not give much,” the number of those wishing to undergo preventive examinations at their place of residence absolutely free of charge and receive medical advice is growing. But according to the polls, there are also quite a few complaints: almost every fourth complains next in line; the fact that it is impossible to pass a professional examination in one day - every sixth.

As follows from the order of the Ministry of Health of the Russian Federation "On the approval of the procedure for conducting medical examination of certain groups of the adult population" (adopted at the end of last year and approved by the Ministry of Justice), in 2018, at least 63% of those Russians who are entitled to it must undergo medical examination (according to the plan), and this is three times more than it was planned in 2017. Since this year, the range of medical services provided to people has also changed.

One of the most important innovations that raised many questions among the population and among legislators: starting in 2018 from the first stage of clinical examination, when patients are checked for signs chronic diseases, clinical and biochemical blood tests, general urine analysis and ultrasound of the abdominal cavity and small pelvis are excluded. According to the Ministry of Health, these tests are ineffective: according to their results, it is not always possible to accurately diagnose or even identify minimal deviations in the system of functioning of certain organs. But in previous years, doctors prescribed these studies precisely in order to identify at an early stage not only non-infectious diseases (diabetes, abnormalities in the work of internal organs), but also oncology of the kidneys, cervix, abdominal cavity, diseases of the bladder and prostate and etc.

Now it is proposed to replace these types of analyzes with a study of feces for occult blood, but it will be carried out more often: not once every three years, but once every two years (helps to diagnose oncology at different stages). And also do a blood test for PSA (prostate-specific antigen) in men. But only as prescribed by local therapists if patients have clinical indications and complaints. And if, according to the results of the medical examination, there are indications for another diagnosis, this will be done within the framework of the compulsory medical insurance free of charge.

There are other changes in the range of medical services: tests to detect colorectal cancer and mammography will be performed more often. Mammography is now compulsory, and women 39–49 years old can undergo it once every 3 years, and 50–70 years old - once every 2 years. And an ECG is required, but not from the age of 21, but only from the age of 35 for men and from 45 for women. But ultrasound of the pelvic organs and ultrasound of the abdominal cavity are no longer required. At the request of the patient, it is possible to pass them (without a special purpose), but not more often than 1 time in 6 years.

All citizens over 38 years of age are required to measure intraocular pressure with an ophthalmologist, check their eyes for glaucoma, etc. And also undergo a check for general dehydration and blood pressure levels. Ages 21 and older can take an HIV test voluntarily, anonymously and free of charge.

Determination of the lipid spectrum of blood, determination of the concentration of glycated hemoglobin in the blood, esophagogastroduodenoscopy (examination of the mucous membranes of organs that enter the gastrointestinal tract) are excluded from the second stage of clinical examination.

The deputies of the Moscow City Duma opposed the exclusion of traditional types of analyzes at the first stage of clinical examination. And they even made a proposal to give Moscow the right to independently determine the list of studies and consultations during medical examination, as our newspaper wrote about. Time will tell how it will be in practice.

Men, too, will not get out

A well-known fact: the stronger sex do not like to go to doctors. But it is surprising: they go to prophylactic medical examination more willingly. The difference with the attendance of women can even be said to be acceptable: 57.9% were women and 42.1% were men (data from 2014). I would like the doctors to have no less of them this year.

Medical examination-2018 will continue to take place in two stages. To whom and what does the state guarantee for free at each stage?

At the first stage: to begin with, doctors should invite the patient to fill out a questionnaire, in which to indicate whether he has any diseases and which ones, to assess the nature of his diet, physical activity. And also whether he smokes, whether he drinks alcohol, whether he takes psychotropic and narcotic substances. All this will allow doctors to assess the risk factors available to him.

Doctors must also record the anthropometric parameters of a person (measure height, weight, waist circumference, determine body mass index). Measure blood pressure. And if a person is over 60, measure also intraocular pressure; do electrocardiography (men 35 and older, women 45 and older); fluorography of the lungs; to conduct a cytological examination of a smear from the cervix (for women from 30 to 60 years old), etc. (according to the list that is available in medical institutions at the place of residence).

Men now too can not get out. All men at the age of 45 and 51 will be able to determine the level of PSA (prostate-specific antigen) in the blood, which can indirectly speak of cancer. And not just selectively, but for medical reasons.

According to the experts, according to the results of the first stage, doctors should identify possible chronic non-infectious diseases (cardiovascular, oncological, bronchopulmonary and diabetes mellitus), as well as their risk factors. And if someone finds out high risk heart problems, obesity, high cholesterol, specialists should be individually consulted. Especially if a person is over 70.

So, the first stage (screening) includes general examinations, according to the results of which a person is assigned a health group and, if necessary, a dispensary observation group. If, according to the results of the first stage of clinical examination, the doctor considers a more in-depth examination necessary, the patient is sent to the second stage. But in any case, the first stage of medical examination should end with a medical examination, recommendations from nutrition specialists, physical activity, advice on how to give up bad habits, etc.

At the second stage:to clarify the state of human health, doctors should offer not only additional methods of various studies, but also consultations of narrow specialists. In addition, duplex scanning of the brachycephalic arteries, colonoscopy, spirometry should be performed. And according to the results, also consult the patient with a urologist, coloproctologist, surgeon. Thanks to such an extensive set of studies, doctors are able to identify chronic non-communicable diseases at an early stage and reduce the likelihood of disability and premature death. Doctors refer to killer diseases as heart ischemia, neoplasms, endocrine diseases, and chronic lung diseases. By the way, this year doctors are advised to pay special attention to any tumors and neoplasms.

The second stage should also end with the examination of patients by a therapist. And according to the profile of found or suspected diseases, send them for further examination in accordance with the standards of medical care.

And according to the results of medical examination, all who underwent it, doctors must assign a health group. There are three of them: first, those with a low risk of developing non-communicable diseases; the second - with a high risk of developing heart and vascular diseases; the third - already having serious chronic diseases. Patients of the second and third groups are subject to obligatory dispensary observation and treatment.

Those who work are obliged to release them for medical examination. In law

Of course, in order to control your health, you must regularly undergo preventive examinations. And every three years, every Russian who has reached the age of 21 has the opportunity to undergo a comprehensive medical examination under the compulsory medical insurance policy. But even so, many Russians postpone visits to doctors until later, either due to lack of time (they are not allowed to leave work), or due to lack of desire. But medical examination is a chance to get rid of many problems, our experts never tire of repeating.

Those who work today have such a chance. According to the law "On the Fundamentals of Health Protection of Citizens in the Russian Federation" (Art. 24 of the Federal Law of the Russian Federation of November 21, 2011 No. 323-FZ), employers are obliged to provide conditions for employees to undergo medical examination and also freely release them to doctors.

In large cities there is now an electronic appointment with doctors. You can also fill out a medical examination questionnaire in advance. People are now reminded of the need to undergo medical examination by phone, they are invited via SMS. True, only the first signs of such mobile services have been outlined.

Experts are convinced that personal responsibility for one's own health is no less, and perhaps more important. Yes, medical examination is voluntary. No one will forcibly drag anyone to the doctors for preventive examinations. But, according to experts, it is a sin not to take advantage of the opportunity to be examined "through and through" free of charge every three years.

AND NOW - ATTENTION!

In 2018, free medical examination can be passed:russians born in the following years from 1928 to 1997 inclusive. Namely: 1928, 1931, 1934, 1937, 1940, 1943, 1946, 1949, 1952, 1955, 1958, 1961, 1964, 1967, 1970, 1973, 1976, 1979, 1982, 1985, 1988, 1991, 1997. intervals, as we can see, are calculated every three years. The entire calendar year in which the person was born is considered to be the time of medical examination. Even if he was born at the end of the year, for example December 31, 1997, a person has the right to undergo medical examination from January 1, 2018. But from January 1, 2019, he already loses this right.

And those Russians who are already at risk (military personnel, veterans of the Great Patriotic War, children of war, children under 18, disabled people of the Chernobyl accident) have the right to undergo a free medical examination not once every 3 years, but every year.

Where to contact?

As explained in the Ministry of Health of the Russian Federation, in order to undergo medical examination, you must come to a medical organization at the place of residence (attachment), to your local therapist (paramedic) or to an office (department) of medical prevention. If you have any questions, contact the representative of your medical insurance organization (the phone number is indicated in the OMS insurance policy). And doctors advise to start bypassing doctors in the morning and come on an empty stomach in order to get tested and not postpone the visit to the next day. It is also necessary to have no intense physical activity for several hours before the examination.

What documents are needed?

Have your passport and medical insurance policy (compulsory medical insurance or voluntary medical insurance) with you. And if someone has the results of tests carried out in the previous 12 months, take them with you too.

Content

People who consider themselves healthy are not always that way. Diseases that can be dealt with at an early stage are determined in an advanced form, it is difficult, and sometimes impossible, to cure them. Clinical examination - a preventive medical examination of the population - helps in the timely diagnosis of serious pathologies. What features does this service have in 2019, what does it include? To maintain health, it is useful to know the types of examinations, analyzes, the procedure for passing.

What is medical examination

The Ministry of Health of the Russian Federation, having studied the statistics of morbidity in the country, in 2013 made a decision on a routine medical examination of the entire population. Medical examination is a free service provided by polyclinics, an easy way to find out the state of your health. Medical checkup:

carried out voluntarily;
covers all groups of adults from the age of 21, children from the moment of birth;
carried out at the place of registration;
requires the presentation of a compulsory medical insurance policy - compulsory medical insurance, a passport.

To undergo a medical examination in the clinic in 2018, it is necessary to find out which year of birth patients should take part in it. There is a special schedule for scheduled inspections. For each age group, it is agreed which procedures are included in the survey. The task of the dispensary medical examination of adults is the timely detection of diseases in patients that affect mortality, the beginning of their treatment. These include:

diseases of the heart, blood vessels, lungs;
oncological pathologies;
chronic non-infectious ailments;
endocrine system diseases;
diabetes.

No less important in 2018 is the dispensary examination of the child, which is carried out according to its own schedule, starting with those who were born in 2001. The list of specialists to be visited has been agreed. Children undergo medical examination in a clinic, kindergarten:

up to a year - monthly;
from 1 to 2 years old - quarterly;
two to three - semiannually;
6-7, 10, 14-15, 16-17 years old - annually.

Schedule of passage by year of birth

Free medical examination of the population helps the patient to save significant sums on medical research. The state allocates huge funds to enable Russian citizens to undergo early diagnosis of dangerous diseases. To make the load on medical institutions uniform, a special schedule for passing medical examinations has been proposed. To determine the period of visiting the clinic, you can:

clarify the schedule on the website of any medical institution that provides such a service;
divide your age by 3, if the result is complete, an examination should be done.

In 2018, dispensary examination must be completed by adult patients and children born during the period, including the start and end dates:

	Period, years	Year of birth
Adults	from 1919 to 1937	1922, 1925, 1928, 1931,1934
	1940 to 1958	1943, 1946, 1949, 1952, 1955
	from 1961 to 1979	1964, 1967, 1970, 1973, 1976
	from 1982 to 2000	1985, 1988, 1994, 1997
	from 2001 to 2017	from 2001 to 2004, inclusive

Objectives of the

Timely diagnostics helps to facilitate the treatment process and prolong the patient's life. The task of conducting a dispensary medical examination in 2018 throughout the country is to identify the state of health of the population. As a result of surveys, the health care system:

has information about the spread of diseases;
identifies risk factors leading to chronic pathologies;
makes adjustments to the methods that are included in the plans for regular surveys of the population.

Objectives of dispensary medical examinations in adults:

early diagnosis of chronic diseases - causes of threat to life, disability, premature death;
in-depth examination by specialists of a narrow profile;
determination of preventive measures;
the appointment of treatment, rehabilitation procedures;
consultation of at-risk patients;
dispensary registration;
an increase in life expectancy, an increase in its quality.

Clinical examination focuses on diseases that often lead to serious consequences. Regular examinations help to preserve and maintain the health of the country's citizens. The list of pathologies that are studied during the physical examination includes:

diseases of the nervous, cardiovascular system;
diabetes;
glaucoma;
pulmonary insufficiency;
malignant neoplasms;
chronic ailments of non-infectious etiology;
diseases of the endocrine system.

The tasks of the dispensary medical examination in 2018 for children are different. The objectives of the event include:

strengthening, maintaining health;
improvement of mental, physical development;
organization of social adaptation;
ensuring hormonal development;
identification of pathologies at an early stage;
timely treatment;
preventive measures to exclude complications, the progression of the disease, the onset of disability.

Changes in the program of general medical examination in 2018

The Ministry of Health of the Russian Federation, based on statistical data, regularly adjusts the measures included in the list of necessary examinations during preventive dispensary medical examinations. Due to the lack of the required equipment in medical institutions, low information content, in 2018 excluded:

general blood analysis;
ultrasonography;
analysis of urine.

As a consequence of the high mortality rate from cardiovascular pathologies, cancer diseases, during the medical examination in 2018, the range of examinations was expanded, which includes with a frequency of once every two years:

Stages of the

A preventive medical examination begins with a visit to a general practitioner, who collects an anamnesis, conducts a questionnaire survey of the patient. The person receives a route sheet, where all examinations that need to be passed are marked. The patient is given a form of a health passport, which is filled out by specialists of a narrow profile. The list of doctors who need to be visited, taking into account the age of the subject and the state of health, includes:

endocrinologist;
cardiologist;
dentist;
ophthalmologist;
gynecologist;
mammologist;
urologist;
neuropathologist.

The therapist receives the conclusions of narrow specialists, the results of analyzes, examinations. Based on the results of the first stage of the preventive medical examination:

assesses the patient's condition;
gives preventive recommendations;
establishes a health group;
makes suggestions for treatment;
issues a passport when surveys are successfully completed.

The preventive medical examination proceeds to the second stage if the patient has:

increased intraocular pressure;
deviations in blood counts;
eCG changes;
pathology of the nervous system;
the likelihood of developing neoplasms;
deviations of the functions of the organs of the genitourinary system of men and women;
the risk of developing a heart attack, vascular pathologies.

Additional clinical examination includes in-depth examination of patients by narrow specialists using special hardware techniques, laboratory tests. At the second stage, doctors' consultations are prescribed:

oncologist;
proctologist;
a surgeon;
coloproctologist;
otorhinolaryngologist;
ophthalmologist;
neurologist;
gynecologist;
urologist;
mammologist.

What examinations are included in the medical examination 2018

A medical examination begins with a visit to a therapist, who fills out a questionnaire with the patient. He determines which doctors are undergoing medical examination in accordance with age, makes notes on the route map about the necessary examinations. The doctor, through a survey, identifies the risk factors for the development of chronic diseases:

the presence of a hereditary predisposition;
physical activity;
diet;
alcohol, drug use;
smoking;
the presence of symptoms of pathologies.

The dispensary medical examination 2018 includes examinations and procedures that are mandatory for all, taking into account the patient's age:

blood test for sugar, cholesterol;
electrocardiogram;
fluorographic examination of the lungs;
smear of the cervical mucosa for women;
mammography of the mammary glands;
analysis of feces for occult blood;
examination by a gynecologist;
appointment with a neurologist;
determination of intraocular pressure.

Visit to therapist and general tests

To undergo a medical examination in a polyclinic, a patient first goes to a general practitioner. The therapist invites him to fill out a special questionnaire, which records the factors that provoke the development of chronic ailments, a predisposition to them. At the initial examination:

blood pressure is measured;
body weight, height is determined;
directions are given for mandatory tests, examinations.

According to the results of the first stage of clinical examination, the therapist:

sums up the results of the medical examination;
sets the patient's health group;
gives recommendations on preventive measures;
if necessary, sends for an in-depth examination by narrow specialists - an oncologist, urologist, surgeon;
prescribes therapeutic measures;
fills out the statistical form and the patient's health passport.

Referral to a neurologist

A visit to this specialist during medical examination is necessary after 51 years. The therapist can send the patient for a neurological examination if indicated. The obligatory consultation includes checking:

memory, thinking by solving problems, memorizing pictures;
spatial sensations - performing actions with closed eyes;
tingling sensation;
facial expressions;
eye movements;
turning the head;
coordination of movements with closed, open eyes.

To clarify the diagnosis, a neurologist may prescribe additional hardware and laboratory tests:

encephalography - determination of brain activity;
electroneuromyography - study of peripheral nerves;
x-ray - examination of the skull, brain;
computed tomography - detailed acquaintance with small defects;
dopplerography - determination of the blood flow rate in the cerebral vessels;
magnetic resonance imaging - study of the work of the cerebral cortex;
blood test for proteins, hormones - identification infectious lesions nervous system.

Gynecologist and mammologist for women

Reproductive health issues are a priority, therefore women should visit a gynecologist annually. During the clinical examination, a survey and examination of patients is carried out, a smear is taken, palpation of the mammary glands is performed to identify pathologies. To detect diseases of the female genital organs, the doctor finds out:

the beginning of the menstrual cycle;
its duration, the nature of the course;
the beginning of sexual activity;
use of oral contraceptives;
regularity of sexual intercourse;
the presence of pregnancies, childbirth, abortions performed.

Breast cancer is widespread in women, but with early diagnosis it can be successfully treated, therefore, the medical examination includes a mammological examination - an X-ray of the mammary glands. If changes are detected, the woman is sent for a consultation with a mammologist, who diagnoses diseases of the mammary glands, sends them for treatment or surgery. The doctor identifies:

benign, malignant neoplasms;
hereditary pathologies;
hormonal disorders that provoke ailments;
inflammatory processes in the chest - mastitis.

ECG for men over 36 years old

The rhythms of modern life, constant stress, poor ecology and bad habits have led to an increase in the number of young men who have problems with the work of the heart and blood vessels. The Ministry of Health of the Russian Federation made a decision to conduct an ECG as part of the medical examination in 2018. The examination results are deciphered by the doctor. The check includes a determination in men after 36 years of age:

regularity of the rhythm;
the size of the heart;
blood supply;
heart rate;
the presence and nature of the teeth, their polarity, size, height.

Conducting an ECG during medical examination helps to assess the state of the cardiovascular system and make a decision on an in-depth examination, the appointment of treatment. The technique helps to identify in young men:

myocardial infarction;
ischemic disease hearts;
tachycardia;
bradycardia;
aneurysm of the heart;
hypertrophy of the ventricles;
extrasystole;
myocarditis;
pericarditis;
myocardial dystrophy;
thromboembolism of the pulmonary artery.

Features of comprehensive diagnostics depending on age

In addition to mandatory studies, during the 2018 prophylactic medical examination, special measures are prescribed that are necessary for patients at risk. The information was collected on the basis of statistical information on the health status of the country's population. Given the age, it is additionally included in the clinical examination of an adult:

When undergoing medical examination, doctors prescribe additional diagnostic procedures taking into account the patient's age:

Study type	Identification of the disease	Age, years
Feces for occult blood	Colon cancer
Abdominal ultrasound	Gastritis, stones, neoplasms
Determination of the level of prostate-specific antigen	Prostate cancer
Visit to a neurologist	Brain lesions
Examination by a mammologist	Neoplasms in the mammary gland
	Cardiac pathology	men after 36 women - from 45

What tests are taken during medical examination in 2018

To detect diseases during a dispensary medical examination, compulsory laboratory tests are carried out. The list includes a blood test that helps to identify the development inflammatory processes, chronic diseases. With its help, the content is determined:

total cholesterol;
glucose;
alanine aminotransaminases;
creatinine levels;
total bilirubin;
aspartate aminotransaminase.

Conducting laboratory tests helps to accurately identify dangerous diseases at the onset of development, take measures to restore the patient's health. During the medical examination in 2018, the list of mandatory tests includes:

feces for occult blood - excludes the appearance of malignant neoplasms of the rectum;
cytological examination of a smear from the cervix in all women under 70 years of age - early diagnosis of cancerous tumors.

How the health group is determined based on the screening results

After conducting examinations during the medical examination in 2018, doctors assign to patients. This is a symbol necessary for the subsequent analysis of a person's condition, the appointment of medical, preventive procedures. In adults, there are three groups. The first is characterized by:

lack of chronic diseases;
maintaining a healthy lifestyle;
rare ailments, colds;
small deviations in blood pressure indicators.

The second group of health, as a rule, includes middle-aged patients, pensioners, which are characterized by:

chronic diseases without complications;
bad habits - smoking, drinking alcohol;
improperly organized food;
limited physical activity;
tendency to develop diabetes mellitus, pathologies of the heart, blood vessels.

According to the results of the medical examination in 2018, the third health group includes patients:

requiring constant supervision of specialists;
having pathologies that worsen the quality of life;
suffering from serious illnesses;
having a disability group with partial or complete incapacity for work;
facing a regular exacerbation of chronic diseases.

During medical examination of children in 2018, 5 health groups are distinguished, depending on the general condition of the patient, the presence of chronic ailments:

the first - no problems with physical, mental health, normal functioning of all organs;
second - chronic diseases are not observed, there is a decrease in immunity, functional disorders, overweight, developmental delay, lack of mass, impaired vision.

The following health groups include children with more serious problems:

third - chronic pathologies in remission, growth retardation, body weight deviations, psychological lag;
fourth - exacerbation of chronic ailments, the consequences of trauma operations, the presence of limitations in studies;
fifth - serious illnesses with frequent seizures, complications, physical developmental defects, organ dysfunctions, disability.

Health passport with examination results

When a patient undergoes medical examination in 2018, he has one more document in his hands, in addition to the outpatient card, route sheet. Health passport - the conclusion of all specialists on the results of examinations. It, along with the medical card, is filled out by each doctor, whose patient has been examined. The document includes:

personal data;
oMS insurance policy number;
belonging to a health group;
recommendations of narrow specialists.

After passing the medical examination, the health passport is handed over to the patient until the next medical examination. The therapist enters into the document:

blood pressure indicators;
heart rate;
test results;
anthropometric data - height, weight;
recommendations on lifestyle, disease prevention;
prescribing additional treatment.

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Discuss

Clinical examination 2018, which is included in the survey of the population in the new year

Comprehensive and large-scale medical examination of citizens of the Russian Federation has been carried out in our country on a regular basis since 2013. Specific directives indicating the procedure and general regulations for its implementation are developed by the Ministry of Health. Nevertheless, there are still discussions in the society: is medical examination in a polyclinic a mandatory procedure? Can you refuse it? Who, according to ministerial instructions, can complete it for free in 2020?

Is it obligatory to undergo medical examination in a polyclinic

Dispensary examination (screening) of the population means a complex of medical measures aimed at diagnosing and examining the main indicators of human health. Routine clinical examination procedures allow detecting possible pathologies in the body in order to prevent adverse consequences, and, as a result, to reduce the mortality rate.

A comprehensive medical examination in the clinic, as well as tests, make it possible to identify a number of diseases that are the cause of 70% of deaths of citizens. These include:

oncological diseases;

cardiovascular disease;

diabetes;

respiratory diseases.

In 2015, the Ministry of Health of the Russian Federation published Order No. 36an dated February 3, 2015, according to which all citizens have the opportunity to undergo a comprehensive health examination absolutely free of charge once every 3 years. According to the legislative directives of the Ministry of Health, clinical examination of the population is of a recommendatory nature and is carried out on a voluntary basis.

On the other hand, not all citizens are in a hurry to comply with the instructions and recommendations related to visiting polyclinics. Moreover, no toughening measures or punishment are applied to those who turn out to be examined. Participation in routine diagnostics concerns exclusively the level of consciousness of citizens in matters of maintaining their own health.

What does a federal medical examination include?

Regardless of whether citizens are registered temporarily or permanently, once every 3 years they have the right to undergo a comprehensive medical examination at a local medical institution absolutely free of charge with a valid compulsory medical insurance policy. Having in hand a passport and a medical insurance policy, a person receives a referral for a procedure that includes several stages.

Stage 1 - initial medical examination to identify any diseases, as well as tendencies to develop them. At the first stage, a person takes basic tests, receives the results and, if a more detailed examination of the identified disease is necessary, is sent for further diagnostics.

Stage 2 - a highly specialized examination of an organ in the work of which pathologies have been identified. Consultations with specialized doctors, additional examinations.

After passing all examinations, the patient is assigned to one of three "health groups": conditionally healthy people are included in group 1, group 2 unites people prone to the development of cardiovascular diseases, group 3 consists of citizens with pronounced signs of diseases.

As a result of the diagnosis, a person receives a Health Passport - this document contains a medical opinion, as well as a list of specialist recommendations for prescribing further treatment.

Who can expect to undergo a free medical examination in 2020

According to generally accepted provisions (Order of the Ministry of Health No. 36an dated February 3, 2015), all citizens of Russia who are 21 years of age can undergo scheduled medical examinations. How to determine the age category that can qualify for a free medical examination in 2020? To do this, a person needs to divide his age by 3, and if the final number is an integer, he can go to the clinic for a medical examination.

In 2020, Russians who were born in 1921, 1924, 1927 and later fall into this category (the defining interval is 3 years). In the category of youth, these are people born in 1993, 1996, 1999.

Unlike adults, children must undergo a mandatory medical examination annually (Order of the Ministry of Health No. 1346n of December 21, 2012). Comprehensive and in-depth medical examination is carried out for children aged 1, 3, 6, 7, 10, 14, 15, 16, 17 years old.

In matters of carrying out activities aimed at preventing the health of adults and children, the state provides all kinds of assistance. To carry out a planned procedure, citizens have the right to exemption from work, and the employer has no right to interfere with these initiatives.

Clinical examination is a medical examination aimed at identifying chronic For example, cardiovascular, bronchopulmonary, cancer, diabetes mellitus.

"\u003e non-communicable diseases, as well as the risk of their development.

Clinical examination provides for examination by specialist doctors and a series of tests and examinations. It is carried out at the place of your attachment. Working citizens are issued on the same day a certificate of passing the examination. During the prophylactic medical examination, employees have the right to be released from work for 1 working day 1 time in 3 years with the preservation of the workplace and average earnings. Medical examinations are also available in the evenings and on Saturdays.

Employees of pre-retirement age (within 5 years before the onset of retirement age) and retirees receiving an old-age or long-service pension have the right to be released from work for 2 working days once a year, while retaining their place of work and average earnings. To do this, you need to agree with the management of the days of the medical examination and write a statement to be released from work.

You have the right to refuse to carry out medical examination in general or from certain types of medical interventions included in the scope of medical examination.

2. Who can get free medical examination in Moscow?

To undergo a medical examination, you must:

3. Suitable for age. Clinical examination is carried out 1 time in 3 years, and you can go through it during the year when you turned or will turn: 18, 21, 24, 27, 30, 33, 36, 39 years old. If you are 40 or more years old, you can undergo medical examination annually.

Some Annual medical examination is carried out:

1. Disabled people of the Great Patriotic War, disabled combatants, participants in the Great Patriotic War who became disabled due to common disease, labor injury or other reasons (except for persons whose disability has occurred as a result of their illegal actions).

2. Persons awarded with the sign "Inhabitant of the besieged Leningrad" and recognized as disabled due to a general illness, work injury or other reasons (except for persons whose disability occurred as a result of their illegal actions).

3. Former underage prisoners of concentration camps, ghettos and other places of detention created by the Nazis and their allies during the Second World War, recognized as disabled due to a general illness, work injury and other reasons (except for persons whose disability was due to their illegal actions).

4. Elderly Muscovites (upon reaching 50 years of age and before the onset of retirement age) have the right to count on free medical examination in medical organizations where a free medical examination program for such citizens is being implemented.

For these categories of citizens, clinical examination is carried out in the amount provided for the nearest age category - except for studies that are contraindicated for annual performance and if there are no corresponding symptoms and diseases for which they are necessary.

"\u003e preferential categories of citizens undergo medical examination annually, regardless of age.

The volume and nature of the comprehensive examination depends on the sex and age of the person.

3. How will the clinical examination take place?

Step 1. Complete the required paperwork.

Contact the polyclinic at the place of attachment, where you will be asked to fill out the following documents:

informed voluntary consent to medical intervention;
a questionnaire (survey) to identify complaints characteristic of non-communicable diseases, personal history and living conditions (smoking, alcohol consumption, diet and physical activity, etc.), in people over 65 years of age - the risk of falls, depression, heart failure, etc. etc.

Step 2. Prepare for examinations.

On the day appointed for the examination, come to the clinic in the morning on an empty stomach, before doing physical activity, including morning exercises. if you If you are from 40 to 64 years old, the test must be taken once every two years, if from 65 to 75 years old - annually.

"\u003e 40 years or more, you will need to donate feces for occult blood, so check with the clinic in advance, If immunochemical, no dietary restrictions are required. If by another method - within 3 days before the examination, refuse food with a high content of iron (meat, apples, white beans), laxatives and enemas, iron preparations, aspirin and ascorbic acid. "\u003e By what method. this analysis is done.

Step 3. Go through the first stage of clinical examination.

A comprehensive survey can consist of two stages. During the first stage, you will receive a route sheet indicating all examinations that must be passed depending on gender and age.

Step 4. Come to your doctor's appointment.

The doctor will give explanations on the results of the examinations, determine your health group, if there is a high risk of diseases or the diseases themselves, the dispensary observation group and will hand over your health passport.

Step 5. Go through the second stage of medical examination.

If, after the examinations, it turns out that you need an additional examination, the therapist will refer you to the second, more in-depth, clinical examination stage.

Step 6. Consult your doctor.

After passing all stages of the examinations, you will have another consultation with a general practitioner who will give the necessary recommendations (for example, on quitting smoking, improving nutrition, increasing physical activity).

In the presence of diseases, the necessary treatment is prescribed, including specialized and high-tech medical assistance, as well as spa treatment.

If you smoke, are overweight, obese, or other risk factors, you may be referred to a prophylaxis unit or office, or to help you manage risk factors.

4. What doctors do I need to see if I am between 18 and 39 years old?

The first stage of medical examination:

1. Preventive medical examination:

survey (questionnaire)
determination of the level of total cholesterol in the blood;
determination of blood glucose levels;
determination of the relative cardiovascular risk (for patients aged 18-39 years);
fluorography (once every 2 years);
reception (examination) based on the results of a preventive medical examination, including examination for the detection of 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 paramedic health center or a paramedic-obstetric center, a general practitioner or a doctor for medical prevention of a department (office) of medical prevention or a health center.

2. Screening for early detection of oncological diseases:

For women:

examination by a paramedic (midwife) (from 18 and older);
taking a smear from the cervix, cytological examination of a smear from the cervix 1 time in 3 years at the age from 18 to 64 years;

3. Brief preventive counseling;

The second stage of medical examinationis carried out for the purpose of additional examination and clarification of the diagnosis of the disease (condition) in the presence of indications based on the results of the first stage and includes:

examination (consultation) by a neurologist;
spirometry;
for women over 18: examination (consultation) by an obstetrician-gynecologist - if necessary;

5. What doctors do I need to see if I am between 40 and 45 years old?

The first stage of medical examination:

measurement of height, body weight, waist circumference, determination of body mass index;
blood pressure measurement;
determination of the absolute cardiovascular risk (for patients from 40 to 64 years old);
resting electrocardiography (performed at the first preventive medical examination, then at the age of 35 and older once a year);
for women over 40 years old - mammography;
for men aged 45 years: determination of prostate-specific antigen (PSA) in the blood;
for patients 45 years old of both sexes - esophagogastroduodenoscopy;
If you are from 40 to 64 years old, the test must be taken once every two years, if from 65 to 75 years old - annually. "\u003e 40 years and older
measurement of intraocular pressure (carried out at the first check-up, then at the age of 40 and older once a year).

examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
examination (consultation) by a surgeon or urologist (for men aged 45 with an increase in the level of prostate-specific antigen in the blood of more than 1 gn / ml);
colonoscopy - in case of suspicion of colon cancer, as prescribed by a surgeon or coloproctologist;
esophagogastroduodenoscopy - in case of suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
x-ray of the lungs, computed tomography of the lungs - in case of suspicion of malignant neoplasms of the lung - as prescribed by the therapist;
examination (consultation) by an ophthalmologist (for patients over 40 years of age with increased intraocular pressure);
individual in-depth preventive counseling or group preventive counseling (patient school).

6. What doctors do I need to go through if I am between 46 and 50 years old?

The first stage of medical examination:

measurement of height, body weight, waist circumference, determination of body mass index;
blood pressure measurement;
holding general analysis blood (hemoglobin, leukocytes, ESR);
determination of the level of total cholesterol in the blood by the express method;
determination of fasting blood glucose levels (use of the express method is allowed);
determination of the absolute cardiovascular risk;
individual preventive counseling - for patients with a high relative and very high absolute cardiovascular risk, obesity, hypercholesterolemia with a total cholesterol level of 8 mmol / l or more and / or who smoke more than 20 cigarettes per day;
fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs were performed in the previous calendar year, or in the year of the clinical examination.);
resting electrocardiography (performed once a year);
for women: examination by a midwife, including taking a smear from the cervix for cytological examination;
for women - mammography;
for men aged 50: determination of prostate-specific antigen (PSA) in the blood;
for patients of both sexes aged If you are from 40 to 64 years old, the test must be taken once every two years, if from 65 to 75 years old - annually. "\u003e 40 years and older: study of feces for occult blood;
measurement of intraocular pressure (carried out once a year).

If during the last 12 months you have taken any of the listed tests or passed any of the listed examinations, their results may be included in the clinical examination.

The second stage of medical examination (if necessary):

duplex scanning of brachycephalic arteries - for men over 45 years old, in the presence of risk factors for the development of chronic non-infectious diseases;
examination (consultation) by a surgeon or urologist (for men aged 50 with an increase in the level of prostate-specific antigen in the blood of more than 1 gn / ml);
examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
colonoscopy - in case of suspicion of colon cancer, as prescribed by a surgeon or coloproctologist;
spirometry - in case of suspicion of chronic broncho-pulmonary disease according to the results of the questionnaire, smokers - according to the referral of the therapist;
for women: examination (consultation) by an obstetrician-gynecologist - if necessary;
esophagogastroduodenoscopy - in case of suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
x-ray of the lungs, computed tomography of the lungs - in case of suspicion of malignant neoplasms of the lung - as prescribed by the therapist;
individual in-depth preventive counseling or group preventive counseling (patient school).

7. What kind of doctors do I need to go through if I am between 51 and 74 years old?

The first stage of medical examination:

measurement of height, body weight, waist circumference, determination of body mass index;
blood pressure measurement;
performing a general blood test (hemoglobin, leukocytes, ESR);
determination of the level of total cholesterol in the blood by the express method;
determination of fasting blood glucose levels (use of the express method is allowed);
determination of the absolute cardiovascular risk (for patients under 64);
individual preventive counseling - for patients under 72 years of age with a high relative and very high absolute cardiovascular risk, obesity, hypercholesterolemia with a total cholesterol level of 8 mmol / l or more and / or who smoke more than 20 cigarettes per day;
fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs were performed in the previous calendar year, or in the year of the clinical examination);
resting electrocardiography;
for patients of both sexes: a study of feces for occult blood (if you are from 40 to 64 years old, the test must be taken once every two years, if from 65 to 75 years old - annually);
for men: determination of the level of prostate-specific antigen in the blood (performed at the age of 55, 60 and 64 years);
for women under 64: examination by a midwife, including taking a smear from the cervix for cytological examination;
for women: mammography (at the age of 40-75 years, it is performed once every 2 years).

If during the last 12 months you have taken any of the listed tests or passed any of the listed examinations, their results may be included in the clinical examination.

The second stage of medical examination (if necessary):

examination (consultation) by a neurologist - in case of suspicion of a previous acute cerebrovascular accident, depression in patients over 65 years of age, with impaired motor function, etc.;
duplex scanning of brachycephalic arteries - for men under 72 years old, for women 54-72 years old, in the presence of risk factors for the development of chronic non-infectious diseases;
examination (consultation) by a surgeon or urologist (for men aged 55, 60 and 64 years - with an increase in the level of prostate-specific antigen in the blood of more than 1 gn / ml);
examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
colonoscopy - in case of suspicion of colon cancer, as prescribed by a surgeon or coloproctologist;
spirometry - in case of suspicion of chronic broncho-pulmonary disease according to the results of the questionnaire, smokers - according to the referral of the therapist;
for women under 75: examination (consultation) by an obstetrician-gynecologist - if necessary;
examination (consultation) by an ophthalmologist - for patients with increased intraocular pressure;
x-ray of the lungs, computed tomography of the lungs - in case of suspicion of malignant neoplasms of the lung - as prescribed by the therapist;
esophagogastroduodenoscopy - in case of suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
examination (consultation) by an otorhinolaryngologist - for patients aged 65 and over (if necessary);
individual in-depth preventive counseling or group preventive counseling (patient school).

8. What kind of doctors do I need to see if I am 75 or more years old?

The first stage of medical examination:

measurement of height, body weight, waist circumference, determination of body mass index;
blood pressure measurement;
performing a general blood test (hemoglobin, leukocytes, ESR);
determination of the level of total cholesterol in the blood by the express method;
determination of fasting blood glucose levels (use of the express method is allowed);
fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs were performed in the previous calendar year, or in the year of the clinical examination);
resting electrocardiography;
measurement of intraocular pressure (carried out once a year);
for women aged 75: mammography;
for patients of both sexes at the age of 75 years: fecal occult blood test.

If during the last 12 months you have taken any of the listed tests or passed any of the listed examinations, their results may be included in the clinical examination.

The second stage of medical examination (if necessary):

examination (consultation) by a neurologist - in case of suspicion of a previous acute cerebrovascular accident, depression in patients over 65 years of age, with impaired motor function, etc.
duplex scanning of brachycephalic arteries - for patients aged 75-90 years, referral by a neurologist;
examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary) - for patients under the age of 87;
spirometry - in case of suspicion of chronic broncho-pulmonary disease according to the results of the questionnaire, smokers - according to the referral of the therapist;
esophagogastroduodenoscopy - in case of suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
x-ray of the lungs, computed tomography of the lungs - in case of suspicion of malignant neoplasms of the lung - as prescribed by the therapist;
examination (consultation) by an otorhinolaryngologist (if necessary);
examination (consultation) by an ophthalmologist - for patients with increased intraocular pressure, and for patients aged 75 years and older who have a decrease in visual acuity that is not amenable to spectacle correction, identified by the results of a questionnaire;
individual in-depth preventive counseling or group preventive counseling (patient school).

9. My age is not on the list for medical examination. What kind of examination can I go through?

If your age is not on the list for medical examination and you do not belong to the preferential categories, you can still contact your clinic and undergo a preventive medical examination. It is also carried out for the early detection of diseases and risk factors for their development, but, unlike clinical examination, it includes a smaller amount of examinations.

The advantage of a preventive medical examination is that it can be done at any age at the request of the patient. Medical examination is free of charge, annually. Prophylactic medical examinations are included in the 1st stage of clinical examination.

measurement of height, body weight, waist circumference, determination of body mass index;

blood pressure measurement;

determination of the level of total cholesterol in the blood by the express method;

determination of blood glucose level by express method;

determination of the relative cardiovascular risk in citizens aged 18 to 39 years;

determination of the absolute cardiovascular risk in citizens aged 40 to 64;

fluorography of the lungs 1 time in 2 years;

resting electrocardiography (performed at the first preventive medical examination, then at the age of 35 and older once a year);

measurement of intraocular pressure (carried out at the first check-up, then at the age of 40 and older once a year);

for women under the age of 39 - examination by a paramedic (midwife) or obstetrician-gynecologist.

Step 2. Find out the results. After the research, you will have an appointment (examination) by a general practitioner, including Examination of the skin, mucous membranes of the lips and oral cavity, palpation of the thyroid gland, lymph nodes.

"\u003e examination for the detection of possible oncological diseases, with the provision of recommendations.

If you have signs or a high risk of illness, your GP will refer you for further testing.

The new procedure will make the examination more targeted, says the head of the Ministry of Health Veronika Skvortsova. In principle, a full cycle of examinations and analyzes allows you to "close" questions with the most common diseases. Cancer screening will now be more active: it is quite possible to identify certain types of oncological diseases at the initial stage, and this should be used.

It is for this reason that the Ministry of Health has provided for a mandatory mammographic examination for women from 39 to 51 years old every 2 years. It was also decided to make more frequent the study to detect rectal cancer (fecal occult blood test). The risk of its occurrence increases with age, therefore, citizens from 49 years old will be examined every 2 years.

On the contrary, some types of research were considered redundant by the Ministry of Health. At least among young citizens. So, electrocardiography, which is necessary to determine the risk of heart and vascular diseases, was previously mandatory from the age of 21. Now the ECG will be performed on men over 35 and women over 45. At the same time, it is envisaged that if the patient has individual indications, the doctor will prescribe the necessary research additionally.

If problems are found during the first stage of clinical examination, the patient is sent to be examined in more depth. For example, if you have high blood pressure, high cholesterol levels, overweight and there is a threat of cerebrovascular accident, you should undergo a scan of the brachycephalic arteries. With an increased PSA indicator, it will be mandatory to consult a urologist or surgeon. If colon cancer is suspected, colonoscopy, etc.

It is now easy not to miss a visit to the doctor: insurance companies have been instructed to inform citizens of certain ages (a full cycle of examinations takes place once every three years, and some types, primarily oncological screening, will be carried out in a year from 2018). So they should be invited to the clinic: by text message, by phone call, by e-mail.

Medical facilities should also try to organize the reception so that the person spends a minimum of time. Many polyclinics set aside Saturday for clinical examination. And yet, much depends on the person himself. A recent survey showed that 70% of citizens reach doctors. But about a third of surveys are still ignored: “no time”, “bad organization”, “poor-quality conduct”, “I do not consider it necessary” - this is how people usually answer the question why they do not want to take care of health for free.

Who can be examined?

Working and non-working citizens from 18 years of age are eligible for free medical examination. Most research is done every 3 years. But some - in a year. Pupils and students are examined in an organized manner.

Clinical examination 2018 - what year of birth are there?

2000, 1997, 1994, 1991, 1988, 1985, 1982, 1979, 1976, 1973, 1970, 1967, 1964, 1961, 1958, 1955, 1952, 1949, 1946, 1943, 1940, 1937, 1934, 1931, 1928, 1925, 1922, 1919

What health guidelines are useful for everyone to know?

1. Blood pressure: the increased level of systolic ("upper") pressure starts from 140 mm Hg. Art., diastolic ("lower") - from 90 mm Hg. Art. Arterial hypertension is one of the main risk factors for the development of vascular and heart diseases.

2. Hypercholesterolemia (high level of total cholesterol) - starting from 5 mmol / l and more. A person does not feel high cholesterol, but this indicator speaks of the risk of developing atherosclerosis.

3. Hyperglycemia - The level of fasting blood plasma glucose is considered to be elevated starting from 6.1 mmol / l and above. This is a key factor that indicates diabetes mellitus. In some cases, the onset of the disease can be stopped by changing the lifestyle: adjusting the diet, increasing physical activity.

4. Overweight... A body mass index (BMI) of 19 to 24.9 is considered normal. It is calculated by the formula: weight in kg divided by height in meters squared (for example, with a weight of 70 kg and a height of 170 cm, BMI \u003d 70 / 1.7x1.7 \u003d 24.2). With a BMI from 25 to 29.9 people are overweight (measures must be taken to lose weight). With a BMI over 30, obesity is diagnosed.