Dispensary by year of birth. Clinical examination: what is included, goals, results

The dispensary complex of events is carried out for citizens aged 21 years and older. This procedure must be carried out every 3 years in order to be sure of the favorable state of one's health and in case of detection of any diseases, immediately take appropriate measures. About what years of birth fall on the medical examination in 2018-2019, read in this article.

Who is expected to be examined in 2018-2019?

Clinical examination is regulated by the Federal Law of November 21, 2011 No. 323-FZ. At the same time, it is carried out voluntarily and free of charge on the basis of the CHI policy. The main task is to identify pathological, acute and chronic diseases, as well as to prevent their development and prevention.

To fulfill their obligations to protect the health of the population and the full coverage of Russian citizens, medical organizations draw up plans for clinical examination, guided by regulatory legal acts. The years of birth of citizens who must undergo a set of medical measures in 2018 and 2019 are presented in the table below.

Table - Years subject to medical examination in 2018-2019

2018	2019
1916, 1919, 1922, 1925, 1928, 1931, 1934, 1937, 1940, 1943, 1946, 1949, 1952, 1955, 1958, 1961, 1964, 1967, 1970, 1973, 1976, 1979, 1982, 1985, 1988, 1991, 1994, 1997	1917, 1920, 1923, 1926, 1929, 1932, 1935, 1938, 1941, 1944, 1947, 1950, 1953, 1956, 1959, 1962, 1965, 1968, 1971, 1974, 1977, 1980, 1983, 1986, 1989, 1992, 1995, 1998

The establishment of age thresholds for medical examinations is due to the fact that, according to statistics and the results of medical practice, it is at a certain age that the risk of a particular disease appears. The procedure under consideration is just designed to identify such a disease at an early stage.

What is included in the procedure?

It is best to start passing the required examinations at the beginning of the year, that is, from January, because, according to statistics, the largest number of citizens come to polyclinics for this purpose towards the end of the year, which creates queues and does not guarantee a fast pace of passing all the necessary specialists. The procedure takes place in stages: first, the general state of health is determined, and then a deeper observation is carried out (if diseases are detected at the first stage).

To undergo an examination, a citizen should go to the hospital at the place of permanent residence. After that, you need to fill out a special form containing basic information about the state of health and lifestyle. Based on the information received, an initial examination will be scheduled. In case of detection of pathological and acute conditions - additional. The primary examination includes a number of medical studies aimed at identifying general health indicators:

• Blood composition (general, for HIV infection, biochemical);
• Identification of pathologies of urine and feces;
• Electrocardiogram;
• Fluorography;
• Gynecological examination (for women).

At a more mature age, in addition to the above, additional studies are carried out. This is due to the fact that the risks of a certain group of diseases are much higher at a specified age threshold. Thus, citizens after 39 years of age will have to undergo the following examinations:

• Fecal analysis (for the presence of blood);
• Urological examination (for men);
• Mammological examination (for women);
• Ultrasound of the digestive organs;
• Examination of vision (definition of violations, the presence of farsightedness or myopia, if necessary - the selection of glasses or contact lenses);
• An examination aimed at identifying circulatory disorders.

The results of the examinations are entered into the patient's outpatient medical book and analyzed by the responsible doctor (therapist, paramedic), who, as a result, can prescribe some preventive measures or write out a referral for an in-depth examination, refer to a narrow specialist.

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

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

Clinical examination includes an examination by specialist doctors and a number of tests and examinations. It is carried out at the place of your attachment. Employed citizens are issued a certificate of inspection on the same day. For the period of medical examination, employees have the right to be released from work for 1 working day once every 3 years with the preservation of their workplace and average earnings. Medical examinations can also be taken in the evenings and on Saturdays.

Employees of pre-retirement age (within 5 years before retirement age) and pensioners receiving an old-age or superannuation pension have the right to be released from work for 2 working days once a year while maintaining their place of work and average earnings. To do this, you need to coordinate with the management the days of medical examination and write an application for release from work.

You have the right to refuse to conduct medical examinations in general or from certain types of medical interventions included in the scope of medical examinations.

2. Who can get a free medical examination in Moscow?

In order to pass the screening, you must:

3. Suitable for age. Medical examination is carried out 1 time in 3 years, and you can pass it during the year when you are or will be: 18, 21, 24, 27, 30, 33, 36, 39 years old. If you are 40 years of age or older, you can have an annual medical examination.

Some Annual medical examinations are carried out by:

1. Disabled people of the Great Patriotic War, invalids of military operations, participants of the Great Patriotic War who became disabled due to a general illness, labor injury or other reasons (except for persons whose disability occurred as a result of their illegal actions).

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

3. Former juvenile 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, labor injury and other reasons (except for persons whose disability was due to their illegal actions).

4. Elderly Muscovites (upon reaching the age of 50 and before the retirement age) have the right to count on free medical examinations in medical organizations that implement a free medical examination program for such citizens.

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

"> privileged categories of citizens undergo medical examination annually, regardless of age.

The volume and nature of a comprehensive examination depend on the gender and age of the person.

3. How will the dispensary take place?

Step 1. Fill out the required documents.

Contact the clinic 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 specific to 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. d.

Step 2 Prepare for examinations.

On the day scheduled for 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 analysis must be taken once every two years, if you are from 65 to 75 years old - annually.

"> 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 other method - within 3 days before the examination, refuse foods high in iron (meat, apples, white beans), laxatives and enemas, iron preparations, aspirin and ascorbic acid. this analysis is done.

Step 3 Pass the first stage of medical examination.

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

Step 4 Come see a general practitioner.

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

Step 5 Pass the second stage of medical examination.

If after examinations it turns out that you need additional examination, the general practitioner will refer you to the second, more in-depth, stage of medical examination.

Step 6 Consult your doctor.

After passing through all stages of 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 care, as well as spa treatment.

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

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

The first stage of dispensary:

1. Preventive medical examination:

• survey (questionnaire)
• determination of the level of total cholesterol in the blood;
• determination of the level of glucose in the blood;
• determination of relative cardiovascular risk (for patients aged 18-39 years);
• fluorography (1 time in 2 years);
• reception (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 membranes of the lips and oral cavity, palpation of the thyroid gland, lymph nodes, by a paramedic of a paramedical health center or a feldsher-obstetric station, by a general practitioner or a doctor for medical prevention of the department (office) of medical prevention or a health center.

2. Screening for early detection of cancer:

For women:

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

3. Brief preventive counseling;

The second stage of dispensary is carried out for the purpose of additional examination and clarification of the diagnosis of the disease (condition) if there are indications based on the results of the first stage and includes:

• examination (consultation) by a neurologist;
• spirometry;
• for women from 18 years old: examination (consultation) by an obstetrician-gynecologist - if necessary;

5. Which doctors should I go to if I am 40 to 45 years old?

The first stage of dispensary:

• measurement of height, body weight, waist circumference, determination of body mass index;
• measurement of blood pressure;
• determination of absolute cardiovascular risk (for patients from 40 to 64 years old);
• electrocardiography at rest (performed at the first passage of a preventive medical examination, then at the age of 35 years and older 1 time per year);
• for women over 40 - mammography;
• for men aged 45 years: determination of prostate-specific antigen (PSA) in the blood;
• for patients aged 45 years of both sexes - esophagogastroduodenoscopy;
• If you are between 40 and 64 years old, the analysis must be taken once every two years, if you are from 65 to 75 years old - annually. "> 40 years and older
• measurement of intraocular pressure (performed during the first routine examination, then at the age of 40 years and older 1 time per year).

• examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
• examination (consultation) by a surgeon or urologist (for men aged 45 years with an increase in the level of prostate-specific antigen in the blood of more than 1 gn/ml);
• colonoscopy - in case of suspected oncological disease of the colon, as prescribed by a surgeon or coloproctologist;
• esophagogastroduodenoscopy - if malignant neoplasms of the esophagus, stomach and duodenum are suspected - as prescribed by the therapist;
• x-ray of the lungs, computed tomography of the lungs - in case of suspected 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. Which doctors do I need to go to if I am 46 to 50 years old?

The first stage of dispensary:

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

If you have had any of the tests listed or any of the tests listed in the last 12 months, your results may be included in your health check.

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-communicable diseases;
• examination (consultation) by a surgeon or urologist (for men aged 50 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 suspected oncological disease of the colon, as prescribed by a surgeon or coloproctologist;
• spirometry - in case of suspicion of a chronic broncho-pulmonary disease according to the results of a questionnaire, smokers - in the direction of a therapist;
• for women: examination (consultation) by an obstetrician-gynecologist - if necessary;
• esophagogastroduodenoscopy - if malignant neoplasms of the esophagus, stomach and duodenum are suspected - as prescribed by the therapist;
• x-ray of the lungs, computed tomography of the lungs - in case of suspected malignant neoplasms of the lung - as prescribed by the therapist;
• individual in-depth preventive counseling or group preventive counseling (patient school).

7. Which doctors do I need to see if I am between 51 and 74 years old?

The first stage of dispensary:

• measurement of height, body weight, waist circumference, determination of body mass index;
• measurement of blood pressure;
• conducting a general blood test (hemoglobin, leukocytes, ESR);
• determination of the level of total cholesterol in the blood by the express method;
• determination of the level of glucose in the blood on an empty stomach (it is allowed to use the express method);
• determination of absolute cardiovascular risk (for patients under 64 years of age);
• individual preventive counseling - for patients under 72 years of age with high relative and very high absolute cardiovascular risk, obesity, hypercholesterolemia with a total cholesterol level of 8 mmol / l or more and / or smokers 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 medical 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 analysis 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 years of age: examination by a midwife, including taking a smear from the cervix for a cytological examination;
• for women: mammography (at the age of 40-75 years is carried out once every 2 years).

If you have had any of the tests listed or any of the tests listed in the last 12 months, your results may be included in your health check.

The second stage of medical examination (if necessary):

• examination (consultation) by a neurologist - in case of suspicion of a previously transferred acute cerebrovascular accident, depression in patients over 65 years of age, with violations of 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-communicable 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 suspected oncological disease of the colon, as prescribed by a surgeon or coloproctologist;
• spirometry - in case of suspicion of a chronic broncho-pulmonary disease according to the results of a questionnaire, smokers - in the direction of a 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 suspected malignant neoplasms of the lung - as prescribed by the therapist;
• esophagogastroduodenoscopy - if malignant neoplasms of the esophagus, stomach and duodenum are suspected - as prescribed by the therapist;
• examination (consultation) by an otorhinolaryngologist - for patients aged 65 years and older (if necessary);
• individual in-depth preventive counseling or group preventive counseling (patient school).

8. What doctors should I see if I am 75 or older?

The first stage of dispensary:

• measurement of height, body weight, waist circumference, determination of body mass index;
• measurement of blood pressure;
• conducting a general blood test (hemoglobin, leukocytes, ESR);
• determination of the level of total cholesterol in the blood by the express method;
• determination of the level of glucose in the blood on an empty stomach (it is allowed to use the express method);
• 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 medical examination);
• resting electrocardiography;
• measurement of intraocular pressure (performed once a year);
• for women aged 75 years: mammography;
• for patients of both sexes aged 75 years: examination of feces for occult blood.

If you have had any of the tests listed or any of the tests listed in the last 12 months, your results may be included in your health check.

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, in case of motor function disorders, etc.
• duplex scanning of brachycephalic arteries - for patients aged 75-90 years in the direction of 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 a chronic broncho-pulmonary disease according to the results of a questionnaire, smokers - in the direction of a therapist;
• esophagogastroduodenoscopy - if malignant neoplasms of the esophagus, stomach and duodenum are suspected - as prescribed by the therapist;
• x-ray of the lungs, computed tomography of the lungs - in case of suspected 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 test can I get?

If your age is not on the list for medical examination and you do not belong to preferential categories, you can still go to 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. Preventive medical examination studies are included in the 1st stage of medical examination.

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

measurement of blood pressure;

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

determination of the level of glucose in the blood by the express method;

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

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

fluorography of the lungs 1 time in 2 years;

electrocardiography at rest (performed at the first passage of a preventive medical examination, then at the age of 35 years and older 1 time per year);

measurement of intraocular pressure (performed during the first routine examination, then at the age of 40 years and older 1 time per year);

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

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

"> examination for the identification of possible oncological diseases, with the provision of recommendations.

If you have signs or a high risk of disease, 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: the detection of certain types of oncological diseases at the initial stage is quite possible, and this should be used.

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

Some types of research, on the contrary, were considered redundant by the Ministry of Health. At least for young people. So, electrocardiography, which is necessary to determine the risk of heart and vascular diseases, used to be mandatory from the age of 21. ECGs will now be performed on men over 35 and women over 45. At the same time, it is provided that if the patient has individual indications, the doctor will prescribe the necessary examination additionally.

If problems are found during the first stage of the medical examination, the patient is sent for a more in-depth examination. For example, if you have high blood pressure, high cholesterol, overweight and there is a threat of cerebrovascular accident, you need to undergo a scan of the brachycephalic arteries. With an elevated PSA, a consultation with a urologist or surgeon will be mandatory. If colon cancer is suspected, a colonoscopy, etc. will be performed.

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

Medical institutions should also try to organize a reception so that a person spends a minimum of time. Many clinics allocate Saturday for medical examination. And yet, much depends on the person himself. A recent survey showed that 70% of citizens reach doctors. But about a third of the survey is still ignored: “no time”, “bad organization”, “poor quality”, “I don’t think it’s necessary” - this is how people usually answer the question why they don’t want to take care of their health for free.

Who can be examined?

Employed and non-working citizens over the age of 18 are entitled to free medical examination. Most studies are carried out every 3 years. But some - in a year. Pupils and students are examined in an organized manner.

Clinical examination 2018 - what years of birth fall into?

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: elevated systolic ("upper") pressure starts at 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(increased level of total cholesterol) - starting from 5 mmol / l and more. A person does not feel high cholesterol, but this indicator indicates the risk of developing atherosclerosis.

3. Hyperglycemia— The level of blood plasma glucose on an empty stomach is considered elevated, starting from 6.1 mmol / l and above. This is a key factor in diabetic disease. In some cases, the onset of the disease can be stopped by changing the lifestyle: adjust the diet, increase 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 ranging from 25 to 29.9, a person is overweight (measures must be taken to lose weight). A BMI over 30 is diagnosed as obese.

The Ministry of Health of the Republic of Sakha (Yakutia) informs: according to the Order of the Ministry of Health of the Russian Federation of October 26, 2017 N 869n “On approval of the procedure for conducting medical examinations for certain groups of the adult population”, the procedure for passing medical examinations by citizens has been changed.

Thanks to the new procedure, medical examinations have become more individualized – if earlier one study was conducted for everyone, regardless of the risk of developing a disease, now studies are regulated by the age range, and are focused on citizens who are at risk of developing certain diseases.

The list of research methods used in medical examinations has been expanded - more active screening has been introduced to detect oncological pathologies at an early stage. If a full cycle of examinations takes place every three years, then oncoscreening from 2018 will be carried out in a year.

In 2018, medical examinations are provided for persons aged: 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

Why is dispensary necessary?

Clinical examination is a complex of medical examinations aimed at identifying and preventing the development of non-communicable diseases. The main purpose of clinical examination is the prevention of chronic diseases, and the early detection of oncological pathologies.

After passing the medical examination, you will receive:

- detailed information about the state of one's own health;

— determination of the health group;

- data on possible risks of developing chronic diseases;

- if necessary, referral for further treatment.

To undergo medical examination, you need to contact the clinic at the place of residence. The direction is issued in the presence of a passport and a compulsory medical insurance policy.

Patients of polyclinics are notified about the beginning of medical examination by means of a telephone call from local therapists.

Representatives of insurance companies provide information about the place and date of the medical examination to the insured in the CHI (compulsory medical insurance) system by using SMS notifications, individual calls, and other contact details specified when filling out an application for a CHI policy.

How is the screening going in 2018?

The screening takes place in two stages. The first stage is a survey (survey).

At the first stage, possible chronic diseases and their risk factors are identified in a person: a patient is interviewed and questioned in order to identify bad habits and risk factors - smoking, drinking alcohol, assessing the nature of nutrition and physical activity, the use of narcotic drugs and psychotropic substances, the nature of nutrition, physical activity. And also, in order to identify in citizens aged 75 years and older the risk of falls, complaints characteristic of osteoporosis, depression, heart failure, uncorrected hearing and vision impairments.

First stage research:

• Anthropometry (measurement of height, weight, waist circumference and determination of BMI - body mass index);
• Measurement of blood pressure;
• Express method for determining the level of total cholesterol and glucose in the blood;
• Measurement of intraocular pressure (after 60 years).
• Electrocardiography (men aged 35 and older, women aged 45 and older).
• Cytological examination of a smear from the cervix (for women from 30 to 60 years old).
• Fluorography;
• Mammography (for women from 39 to 48 years old - 1 time in 3 years, for women from 50 to 70 years old - 1 time in 2 years).
• Examination of feces for occult blood by the immunochemical method (1 time in 2 years from 49 to 73 years).
• Determination of PSA in the blood of men at 45 years and at 51 years.
• HIV testing (from 21 years old).

General and biochemical blood tests, urinalysis, ultrasound of the abdominal organs, as well as studies limited by age, will be carried out only if there are complaints.

Health groups:

According to the results of the first stage of medical examination, all patients are divided into three health groups: the first group is relatively healthy, the second group is people with a high risk of developing chronic non-communicable diseases, and the third group is sick.

The second stage of clinical examination is carried out to clarify the state of human health with the help of additional examination methods and consultations of narrow specialists.

The second stage is:

The second stage of medical examination takes place more individually, based on the results of the first stage, if there are indications for examination.

• Examination 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 detection of motor function disorders, cognitive impairments and suspicions of depression in citizens in aged 75 years and older, who are not under dispensary observation on this occasion);

• Duplex scanning of the brachycephalic arteries (for men aged 45 to 72 years and women aged 54 to 72 years with a combination of three risk factors for chronic noncommunicable diseases: high blood pressure, hypercholesterolemia, overweight or obesity, and referral by a neurologist with a first identified indication or suspicion of a previously suffered acute cerebrovascular accident for citizens aged 75–90 years who are not under dispensary observation for this reason)

• Consultation with a urologist or surgeon, with elevated PSA in the blood - more than 1 nanogram per milliliter (for men aged 45 and 51 years with an increase in the level of prostate-specific antigen in the blood of more than 1 ng / ml, to rule out prostate cancer)

• Examination by a coloproctologist or surgeon with a positive fecal occult blood test with a referral for further examination - sigmoidoscopy, fibrocolonoscopy. (for citizens aged 49 years and older with aggravated heredity due to familial adenomatosis, oncological diseases of the colorectal area, 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 detection of symptoms of oncological diseases of the colorectal area);

• Spirometry for suspected diseases of the respiratory system in smokers (for citizens with suspected chronic broncho-pulmonary disease based on the results of the questionnaire)

• Examination by a gynecologist when changing the cervical smear or mammography. (for women aged 30 to 69 years inclusive with identified pathological changes based on the results of a cytological examination of a smear from the cervix and (or) mammography)
• Examination by an otorhinolaryngologist (for citizens aged 75 years and older if there are medical indications based on the results of a questionnaire or examination by a general practitioner)

• Examination by an ophthalmologist (for citizens aged 60 years and older with increased intraocular pressure, and for citizens aged 75 years and older who have a decrease in visual acuity that is not amenable to spectacle correction)

The second stage ends with an examination by the therapist. Based on the results, if there are indications, a person can be referred for further examination and / or treatment in the direction of a specialist.

Before you come to the clinic on the appointed day, you must not eat for several hours (take tests on an empty stomach) and not have intense physical activity. Take a plastic medical container with morning urine with you. Citizens over 45 years of age, you must first prepare a fecal occult blood test. Be sure to take your passport and OMS policy with you.

More about health groups

I health group- citizens who have not been diagnosed with chronic non-communicable diseases, do not have risk factors for developing 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).

As part of the first stage of medical examination, such citizens receive a brief preventive consultation by a general practitioner, including recommendations on a healthy diet, level of physical activity, cessation of tobacco smoking and harmful alcohol consumption, and persons with a high relative cardiovascular risk additionally in the department (office) of the medical prevention (health center, feldsher's health center or feldsher's obstetric station), individual preventive counseling is carried out.

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).

As part of the first stage of medical examination, such citizens are given a brief preventive consultation by a general practitioner. Persons with a high or very high absolute cardiovascular risk, and (or) smoking more than 20 cigarettes per day, and (or) who have obesity, and (or) hypercholesterolemia, with a total cholesterol level of 8 mmol / l or more, are individual preventive counseling in the department (office) of medical prevention, health center, feldsher health center or feldsher-obstetric station. Citizens with an identified risk of harmful alcohol consumption and (or) the risk of using narcotic drugs and psychotropic substances without a doctor's prescription are given in-depth (individual or group) preventive counseling at the second stage of medical examination.

Citizens II health group if there are medical indications, the general practitioner prescribes drugs for medical use in order to pharmacologically correct the identified risk factors. Citizens of the II group of health 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 a paramedic of a medical assistant's health center or a medical and obstetric station, with the exception of patients with a total cholesterol level of 8 mmol / l and more, which are subject to dispensary observation by a general practitioner.

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. According to the results of an additional examination, the health group of a citizen can be changed. If a patient has chronic non-communicable diseases and other diseases (conditions) requiring dispensary observation, he is included in the IIIa health group.

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 medical, rehabilitation and preventive measures.

Citizens of IIIa and IIIb health groups who have risk factors for the development of chronic non-communicable diseases, as part of the first stage of clinical examination, a brief preventive consultation is carried out by a general practitioner. As part of the second stage of medical examination, citizens under the age of 72 years with diagnosed coronary heart disease, cerebrovascular diseases, chronic ischemia of the lower extremities of atherosclerotic origin or diseases characterized by high blood pressure, and all citizens aged 75 years and older in order to correct the identified risk factors and (or) the prevention of senile asthenia, in-depth (individual or group) preventive counseling is carried out in the department (office) of medical prevention, a health center, a feldsher health center or a feldsher-obstetric station. If there are medical indications, the general practitioner prescribes drugs for medical use in order to pharmacologically correct the identified risk factors.

The older a person becomes, the more often he needs to undergo a preventive examination to identify hidden diseases and risk factors. And once every three years, every citizen of our country can do this for free - at the expense of the state, which assumes all the costs of universal medical examination. Alexander Ivanov, candidate of medical sciences, osteopath, neurologist, spoke about why this opportunity should not be neglected, and about various aspects of clinical examination in his new article.

PREVENTION IS EASIER THAN TREAT!

One of the measures taken by the state to take care of the health of the population is medical examination, that is, a preventive examination of people who have no complaints.

In our country, medical examination has been resumed since 2012. In 2015, the order of the Ministry of Health of the Russian Federation No. 36 was published, which declares the right of all citizens of the Russian Federation who have reached the age of 21 to a free medical examination once every three years.

The idea is undoubtedly wonderful and is aimed at identifying the first signs of diseases that a person does not even know about. Prevention is easier than cure. Russia has a high mortality rate from diseases of the cardiovascular system, oncology, diabetes and lung diseases. The general medical examination of the country's population is aimed at preventing these socially significant diseases.

WHERE DOES THE DISPENSERIZATION TAKE PLACE, WHO HAS THE RIGHT

According to Order No. 36 of the Ministry of the Interior of the Russian Federation, clinical examination is a voluntary matter, no one will punish you if you suddenly do not pass it. But it is important to remember that this year people born in the following years (see Figure 1) have the right to undergo a list of approved studies and consultations free of charge according to the order of the Ministry of Health. So, in 2018, citizens of the Russian Federation born in:

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

To undergo medical examination, you can contact the clinic at the place of residence (where you are attached), and the medical institution has no right to refuse you. The direction is issued in the presence of a passport and a compulsory medical insurance policy. If you work, then the employer, according to the legislation of the Russian Federation, does not have the right to interfere with your medical examination.

HOW DOES THE DISPENSERIZATION GO

The screening takes place in two stages. At the first stage, possible chronic diseases and their risk factors are identified in a person: a patient is interviewed and questioned in order to identify bad habits and risk factors (smoking, drinking alcohol, taking psychotropic and narcotic substances, assessing the nature of nutrition, physical activity). In addition, the following is carried out:

• Anthropometry (measurement of height, weight, waist circumference and determination of BMI - body mass index).
• Measurement of blood pressure.
• Express method for determining the level of total cholesterol and glucose in the blood; measurement of intraocular pressure (after 60 years).
• Electrocardiography (men aged 35 and older, women aged 45 and older).
• Cytological examination of a smear from the cervix (for women from 30 to 60 years old).
• Fluorography.
• Mammography (for women from 39 to 48 years old - 1 time in 3 years, for women from 50 to 70 years old - 1 time in 2 years).
• Examination of feces for occult blood by the immunochemical method (1 time in 2 years from 49 to 73 years).
• Determination of PSA in the blood of men at 45 years and at 51 years.
• HIV testing (from 21 years old).

This year, clinical and biochemical blood tests, urinalysis, as well as ultrasound of the abdominal organs were removed from the initial stage of medical examination. They will be done if there are complaints.

The first stage ends with an examination and consultation of a therapist, a health group is determined, recommendations are given on nutrition, physical activity, and indications for the second stage of medical examination are determined.

According to the results of the initial stage of screening, all patients are divided into three health groups: the first group is relatively healthy, the second group is people with a high risk of developing heart and vascular diseases, and the third group is sick. The third group is subject to mandatory dispensary observation and treatment.

The second stage of medical examination is carried out to clarify the state of human health with the help of additional examination methods. It may include consultations of narrow specialists.

So the second step is:

• Examination by a neurologist in case of suspected acute cerebrovascular accident.
• Duplex scanning of brachycephalic arteries.
• Consultation of a urologist or surgeon with an elevated PSA in the blood of more than 1 nanogram per milliliter.
• Examination by a coloproctologist or surgeon with a positive fecal occult blood test with a referral for further examination - sigmoidoscopy, fibrocolonoscopy.
• Spirometry for suspected diseases of the respiratory system and in smokers.
• Examination by a gynecologist when changing the cervical smear or mammography.
• Examination by an ENT doctor and an ophthalmologist.

The second stage ends with an examination by the therapist. If necessary, a person is sent for further additional examination on the recommendation of a specialist doctor.

HOW TO PREPARE FOR DISPENSERIZATION

Before coming to the clinic on the appointed day, you must not eat for several hours (take tests on an empty stomach) and not have intense physical activity. Take a jar of morning urine (150 milliliters) with you. If you are over 45 years old, then you need to prepare a fecal occult blood test. If you have previous test results, be sure to bring them with you. The second stage of medical examination takes place more individually, based on the results of the first stage. Do not forget the CHI policy and passport!

HEALTH SYSTEM "SEVEN D" ACCORDING TO IVANOV

In my author's health improvement system "Seven D", clinical examination is mandatory, and the frequency of its implementation is at least once a year, starting from the age of 25. In addition to the above analyzes and studies under the mandatory 2018 medical examination program, I recommend supplementing your health picture with information about the following parameters (of course, these procedures are paid for on their own):

• Serum iron level, ferritin.
• Microelements and macroelements (zinc, selenium, magnesium, calcium, sulfur, chromium, iodine).
• Heavy metals (mercury, lead, aluminum, cadmium)
• Vitamin D.
• Vitamin B12.
• Folic acid.
• Omega-3 index.

These indicators can significantly affect the level of your health and the prognosis of the duration and quality of life.

SUMMARY

2. Clinical examination is aimed at identifying chronic diseases and risk factors for their formation, which ultimately improves the quality and length of human life.

3. You can undergo a medical examination at the clinic at the place of residence, for this you need a compulsory medical insurance policy and a passport.

4. Clinical examination takes place in two stages, according to the results of which health groups are formed, diseases are detected and treatment and dispensary observation are carried out.

5. You can supplement information about your health with additional studies (microelements, macroelements, vitamins, heavy metals), but this is no longer included in the standard paid by the state, however, knowledge of these data and their correction can significantly affect human health.

Take care of yourself and be healthy!

Alexander Ivanov