The catastrophic deterioration of people's living standards, high mortality, the demographic crisis prompted the state to pay close attention to the health of citizens. A medical examination plan was introduced, which provides for a comprehensive examination of the body of the applied patient for detectable diseases. The system works recently, few people know about the procedure. The free medical examination required for adults and children in 2018 - what is included in the survey, many citizens who care about their health would like to clarify.

What is dispensary

Many citizens seek medical help when the disease is at an incurable stage, and it is almost impossible to do anything to help the patient. If, however, an ailment is detected in the early stages of development, when it quietly smolders in the body, then a person can be effectively cured, improving the quality of life. A comprehensive examination of the body with devices, consultations of specialists of various profiles, sampling of tests includes medical examination. You can get tested free of charge once every three years. Some categories of citizens can be tested annually.

Russians do not like to visit a polyclinic for no reason - no one likes to push in lines, to be among patients with a risk of catching an infection, so many people want to know what is included in the adult medical examination, which doctors should be visited, what tests to pass. Dispensary examination is a voluntary matter, no one will force a person to undergo screening, the state simply encourages people to take care of their health by providing free medical services.

Goals

Comprehensive diagnostics is aimed at identifying chronic diseases by various examination methods. Statistics say that Russians of different age groups die from cardiovascular, cancerous, endocrine and pulmonary ailments in descending order. The primary examination is aimed at detecting diseases of this type. Early diagnosis allows you to successfully treat ailments, take preventive measures against the development of diseases, form the right attitude towards the health of adult and minor members of society.

Program

Medical institutions that have the right to engage in medical examinations are guided by the order of the Ministry of Health of Russia dated 03.02.2015 No. No. 36an, adopted on the basis of articles 6724, 6175 of the Federal Law No. 323 dated November 21, 2011, establishing the right to conduct diagnostic examinations once every three years for the following categories of adult Russians:

  • working;
  • unemployed;
  • full-time students in secondary special and higher educational institutions.

Some citizens may undergo a medical examination annually. These include:

  • invalids of the Great Patriotic War, military actions;
  • residents of besieged Leningrad who have an appropriate certificate;
  • prisoners of Nazi concentration camps.

The procedure for passing the examination of the body includes two stages of clinical examination. At the first stage, patients with a tendency to develop chronic non-infectious diseases are identified. If a patient has a disease or a tendency to it due to an unhealthy lifestyle, alcohol consumption, genetic predisposition, or other factors, then a second, in-depth, stage of the study is carried out to clarify the diagnosis. Based on the results of examinations that are part of the general medical examination system, a person is issued a Health Passport.

Organization

As part of the mandatory system of medical insurance of the population, medical examinations take place in a polyclinic, a hospital, an ambulance station involved in the provision of free medical services to the population. A citizen can come for screening to identify chronic ailments at the outpatient department at the place of registration. Responsible for the provision of services are the head of the medical organization, doctors, paramedics participating in the program.

What is included in the dispensary

Children aged 1-17 undergo a mandatory medical examination in 3-year increments. For adult Russians, the approach is different. Doctors check the probability of entering the risk category at the medical examination, so you will have to undergo a comprehensive examination, including various screening procedures, at the first stage of the medical examination. The second stage includes an in-depth study of the body, carried out according to medical recommendations with specific procedures and consultations of narrow specialists.

Planned

The method of passing a preventive examination includes a systematic study of the work of human vital systems. Doctors are looking for a "weak link" that can lead to serious illness. At the first stage, the medical examination includes the following studies:

  • establishment of anthropometric data (height, weight, mass index);
  • checking the levels of upper and lower pressure;
  • blood sampling for clinical, biochemical analysis, as well as for glucose and cholesterol;
  • ECG for men over 35 years old, women over 45 years old;
  • a smear for cytology from the surface of the cervix in women under 69 years of age;
  • fluorogram;
  • Analysis of urine;
  • mammogram of the breast of women aged 39-75;
  • Ultrasound of the abdominal cavity of persons over 39 years of age, of the abdominal aorta for people who worked in hazardous conditions, smoked, inhaled vapors of toxic substances;
  • taking feces for blood;
  • measurement of intraocular pressure;
  • therapist consultation.

Additional

If a person has deviations from normal indicators, then an additional medical examination is carried out. The second stage includes the following procedures, according to the testimony of the therapist who made the conclusions at the first stage of the medical examination:

  • gastroduodenoscopy;
  • diagnostics of the arteries supplying the brain with oxygen;
  • colonoscopy;
  • spirometry;
  • specific blood tests.

Which doctors are undergoing medical examination

The initial stage of the clinical examination includes a consultation with a general practitioner, a local doctor, who decides, based on the analyzes of the person who applied, about the need for further examination. You may need to contact the following professionals:

  • urologist, men 42-69 years old with suspected prostate cancer;
  • cardiologist;
  • endocrinologist;
  • neurologist
  • pulmonologist, citizens working in hazardous industries;
  • surgeon and (or) coloproctologist for persons over 45 years of age;
  • gynecologist, women with pathological changes in the tissues of the cervix;
  • ophthalmologist, persons over 39 years of age with low intraocular pressure, citizens over 75 years of age with increased intraocular pressure.

adults

People engaged in work in hazardous and hazardous industries may require an examination by an oncologist, pulmonologist, gastroenterologist during medical examination. If a woman 35-75 years old has unfavorable breast examination data, then an examination by a mammologist is indicated. Examination of the surgeon is included in the procedure of the second stage of clinical examination, if a person has abnormalities in the functioning of the body that require urgent surgical intervention.

Children

Children undergo clinical examination, which includes visits to a pediatrician, neurologist, cardiologist, orthopedist, otorhinolaryngologist, ophthalmologist every quarter until the kids reach 1 year old. After three years, you will have to go through the above specialists, an andrologist for boys, a gynecologist for girls, a psychologist, a speech therapist when entering preschool institutions. Further, every 3 years the child undergoes a mandatory medical examination organized by the school institution.

What tests are taken during the medical examination

The planned procedure includes standard, biochemical blood tests, glucose and cholesterol tests, urine sampling for clinical analysis. Women take a smear from the vagina for a histological examination of tissue cells. The secondary check includes tests according to the doctor's indications. These may include the following types of blood tests:

  • lipid spectrum diagnostics;
  • the degree of concentration of glycohemoglobin;
  • level of prostate-specific antigen.

Video

Attention! The information provided in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can make a diagnosis and give recommendations for treatment, based on the individual characteristics of a particular patient.

Did you find an error in the text? Select it, press Ctrl + Enter and we'll fix it!

Discuss

Clinical examination 2018 - what is included in the examination, doctors and tests

Why do you need dispensary ?

Many chronic diseases in the early stages are asymptomatic, therefore, the sooner the initial manifestations of the disease or the risk of their development are identified, the more successful the treatment will be.

It is for these purposes that clinical examination is carried out, which, in addition to the early detection of diseases and their risk factors, ensures the necessary therapeutic and preventive measures, and, if necessary, long-term follow-up.

Who is subject to screening?

Medical examination is carried out from the age of 18. The following population groups are subject to medical examination:

1) working citizens;

2) non-working citizens;

3) students in educational institutions full-time. You can pass it during the year when you turned or will turn out: 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.

The main tasks of medical examination

Identification of chronic non-communicable diseases that are the main cause of disability and premature death, which include:

Cardiovascular diseases, primarily coronary heart disease and cerebrovascular disease;

Some malignant neoplasms;

Diabetes;

Chronic respiratory diseases, tuberculosis.

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

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

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

3) conducting brief preventive counseling of citizens with identified chronic non-communicable diseases and (or) risk factors for their development, healthy citizens, as well as conducting individual in-depth preventive counseling and group preventive counseling (patient schools) of citizens with high and very high total cardiovascular risk ;

4) determination of the dispensary observation group of citizens with identified chronic non-communicable diseases and other diseases (conditions), as well as citizens with high and very high total cardiovascular risk.

Features of the medical examination:

Precinct principle of its organization;

A differentiated set of examinations depending on age and gender (in order to increase the likelihood of early detection of the most common chronic non-communicable diseases for a given gender and age);

What documents are required for medical examination?

Each citizen going for a medical examination must have a passport and a compulsory medical insurance policy. If you underwent medical examinations in the current or previous year, take the documents confirming this and show them to medical workers before starting the medical examination.

The order of passing medical examination.

The medical examination program includes, first of all, all the studies and analyzes that are included in the annual medical examination. Preventive medical examination is carried out for early detection of conditions, diseases and risk factors for their development, non-medical use of narcotic drugs and psychotropic substances, as well as in order to determine health groups and develop recommendations for patients and includes:

● Fluorography (1 time in 2 years);

● Poll (questionnaire);

● Anthropometry (height, weight, waist circumference are measured);

● Blood pressure measurement;

● Blood test for total cholesterol;

● Blood glucose test;

● Determination of cardiovascular risk (relative - from 18 to 39 years old, absolute - from 40 to 64 years old), risks of chronic diseases;

● Measurement of intraocular pressure (at the first medical examination, annually - from the age of 40);

● ECG (at the first medical examination, annually - from the age of 35);

● For women - examination by a gynecologist.

The dispensary is carried out in two stages. The first stage of the examination is necessary in order to identify signs of chronic non-communicable diseases and the risks of their development. Those who, based on the results of the first stage of medical examination, need additional examination or preventive counseling are referred by a general practitioner to the second stage of medical examination. The second stage of medical examination is carried out on the basis of the results of the first. It includes consultations of highly specialized specialists and clarification of the diagnosis.

Research at the first stage of medical examination of the adult population

Prophylactic medical examination itself is a set of measures that includes a preventive medical examination and additional methods of examinations conducted to assess the state of health (including the definition of a health group and a dispensary observation group).

In addition to the above-mentioned medical examination measures during the adult population medical examination, the following are carried out at the first stage:

  • complete blood count (hemoglobin, leukocytes, ESR) - from the age of 40;
  • examination of feces for occult blood (from the age of 40 - 1 time in 2 years, from the age of 65 - annually);
  • at 45 years old - FGS;
  • for women: a cytological examination of a cervical smear (from 40 years old - 1 time in 3 years), mammography (from 40 years old - 1 time in 2 years, from 65 years old - annually).
  • for men: determination of prostate-specific antigen (PSA) in the blood (at 45, 50, 55, 60, 64 years).

Additional examination at the second stage of medical examination of adults

At the second stage of medical examination, studies are carried out when the patient is assigned to a risk group or deviations are detected. In this case, assigned:

  • consultations of specialists (neurologist, otorhinolaryngologist, ophthalmologist, surgeon, etc.);
  • additional studies (colonoscopy, ultrasound, FGDS, CT scan of the lungs, etc.).

Preparation for the medical examination:

To pass the first stage of medical examination it is advisable to come to a medical organization (polyclinic) in the morning, on an empty stomach, before performing any physical activity, including morning physical exercises. Take with you a morning portion of urine in the amount of 100-150 ml. Before collecting urine, be sure to make a thorough toilet of the genitals. To collect urine and feces it is preferable to use commercially produced special containers (small containers) for bioassays, which can be purchased at a pharmacy. For urine analysis, you need to collect an average portion of urine (start urinating, and then after 2-3 seconds substitute a container to collect the analysis). Given the fact that some products (beets, carrots) are able to stain urine, they should not be consumed within a day before the analysis. Citizens who take diuretics should, if possible, stop taking them, since these drugs change the specific gravity, acidity and amount of urine excreted. A relative limitation is the menstrual period in women. It is desirable that the urine sample be submitted to the laboratory within 1.5 hours after collection. Transportation of urine should be carried out only at positive temperatures, otherwise the precipitated salts can be interpreted as a manifestation of renal pathology, or hinder the research process. In this case, the analysis will have to be repeated.

To test stool for occult blood it is necessary to avoid false positive results within 3 days before the medical examination, do not eat meat food, as well as other products that contain a significant amount of iron (apples, green onions, sweet bell peppers, white beans, spinach), as well as vegetables containing a lot enzymes such as catalase and peroxidase (cucumbers, horseradish, cauliflower), exclude iron-containing drugs, including hematogen, stop taking ascorbic acid, acetylsalicylic acid (aspirin) and other non-steroidal anti-inflammatory drugs (such as voltaren, diclofenac, etc. .d.), refuse to use any laxatives and enemas. Avoid excessive liquefaction of the stool specimen with toilet bowl water. This may cause an incorrect result.

Women it must be remembered that the collection of smears from the cervix is ​​not carried out during menstruation, when carrying out one or another treatment of infectious and inflammatory diseases of the pelvic organs, that in order to reduce the likelihood of obtaining false results of the smear analysis, it is necessary to exclude sexual contacts for 2 days before medical examination , cancel any vaginal preparations, spermicides, tampons and douches. Mammography carried out from 6 to 12 days of the menstrual cycle.

The volume of preparation for passing the second stage of medical examination will be explained to you by the district doctor (paramedic).

IMPORTANT!

At present, Art. 185.1 of the Labor Code of the Russian Federation establishes the allocation of paid days for medical examination for the working population: 1 day every 3 years - as a general rule, 2 days annually - for pre-pensioners and pensioners.

What happens if during the medical examination a patient is diagnosed with deviations in health?

After all the studies and consultations of specialists, the patient is examined by a district general practitioner (GP). Based on the results of the medical examination, for planning the tactics of his medical supervision, the health group is determined:

I group of health status- citizens who do not have chronic non-communicable diseases, do not have risk factors for the development of such diseases or have these risk factors with low or medium absolute total cardiovascular risk and who do not need dispensary observation for other diseases (conditions). Within the framework of medical examination, such citizens are given brief preventive counseling;

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

Within the framework of medical examination, such citizens undergo correction of risk factors for the development of chronic non-communicable diseases (in-depth individual preventive counseling and (or) group preventive counseling) in the health center, if there are medical indications, the general practitioner prescribes drugs for medical use in order to pharmacologically correct these risk factors . These citizens are subject to dispensary observation by the attending physician;

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

IIIb group of health status- 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 status groups are subject to dispensary observation by a general practitioner, medical specialists with medical, rehabilitation and preventive measures. Citizens with health status group IIIa, who have risk factors for the development of chronic non-communicable diseases, and citizens with health status group IIIb, who have high and very high total (absolute or relative) cardiovascular risk, the existing risk factors are corrected (in-depth individual preventive counseling and (or) group preventive counseling) within the framework of clinical examination

Can a patient refuse research?

Clinical examination is carried out if there is an informed voluntary consent of a citizen or his legal representative (in relation to a person recognized as legally incompetent, if such a person is unable to consent to medical intervention due to his condition), given in the form and in the manner approved by the Ministry of Health Russian Federation. A citizen has the right to refuse to conduct medical examinations in general or from certain types of medical interventions included in the scope of medical examinations, in the manner and in the form approved by the Ministry of Health of the Russian Federation.


Clinical examination allows you to improve your health, identify the disease and, as early as possible, treat the disease with the greatest success.

Conducting a general medical examination in our country began in 2013. This is a kind of return to the traditions that existed in Soviet times. They included a scheduled medical examination aimed at determining the health status of each person: a worker, a student, the unemployed and a pensioner.

Currently, mandatory medical examinations are carried out everywhere: in large and small cities and villages. The main purpose of such an examination is the timely detection of various diseases and referral for treatment.

What is dispensary?

In the medical dictionary, this word denotes a certain concept of treatment and prevention activities that are carried out in specialized medical institutions. Such work is regulated by relevant regulations. The documents indicate the exact scope of medical consultation and research, as well as the time of their implementation. At the enterprises, a special order is created on the planned examination of workers who need medical examination.

All activities are carried out at the place of residence of the patient in a medical institution. Any person has the right to completely or partially refuse such an examination. To do this, you will need to formalize your unwillingness in writing and present it to the therapist.

Medical examination is of great importance for maintaining the health of the population. Many diseases do not show any signs for a long time and do not manifest themselves at all. Often, such ailments have serious consequences that threaten not only the health, but also the life of the patient. Based on this, it can be said that The main advantage of the examination is the early diagnosis of existing diseases.. In the initial stages, the disease is much easier to cure.

A full examination includes a whole range of activities that allow you to comprehensively assess the health status of each person. The annual passage of such an examination significantly reduces the risk of developing serious diseases, often leading to disability or death.

Medical examination goals

The main function of early diagnosis, carried out as part of the medical examination, is considered to be the timely determination of the presence of serious diseases, such as:

  • diseases of the cardiovascular system, central nervous system;
  • various neoplasms, malignant and benign;
  • diabetes;
  • chronic disorders in the functioning of the respiratory system.

Almost 75% of deaths occur precisely because of the above diseases. The physical examination is aimed primarily at identifying alarming symptoms, as well as risk factors that often lead to serious consequences. These include:

  • high blood pressure;
  • an increase in the amount of glucose in the blood (hyperglycemia);
  • excess of normal levels of cholesterol;
  • alcohol abuse;
  • sedentary lifestyle;
  • smoking;
  • overweight;
  • unhealthy food.

People who undergo an examination have the opportunity to get professional advice from doctors, which reduces the risk of developing dangerous diseases. The main goal of such events is to maintain health and increase life expectancy of the population.

What is the essence of the medical examination and what does it include? The entire examination consists of two stages, as well as laboratory tests.

First stage

Initially, non-communicable diseases are identified, which include disorders of the functioning of the cardiovascular system, cancer, glaucoma, diabetes, and others. The main task of this stage is to diagnose the existing risks that threaten human health. This should also include the identification of the use of psychotropic and narcotic drugs that are not due to the appointment of a specialist.

To carry out the activities of the initial stage of the survey, you will need to visit the medical facility twice. The first visit takes 2-6 hours. As a rule, a referral for medical examination does not require exhausting standing in line, but it takes quite a lot of time for the specialists to work. The patient should undergo a preventive examination by the following doctors:

  • therapist;
  • gynecologist;
  • neurologist;
  • ophthalmologist;
  • surgeon.

Laboratory research

What analyzes and studies are typical for the primary stage? The exact list of necessary procedures is indicated in the bypass sheet, which is issued to each patient. This list is formed on the basis of individual parameters: living conditions, medical history. The dispensary set includes the following studies:

  • measurement of blood pressure;
  • using express methods, the level of cholesterol and sugar in the blood is determined;
  • general and clinical analysis of blood;
  • urine test;
  • coprogram;
  • fluorography;
  • identification of predisposition to the development of problems with the cardiovascular system;
  • mammography;
  • fixing intraocular pressure;
  • the study of scraping of the cervical canal and cervix in women;
  • Ultrasound of the abdominal organs.

The question is relevant: is it necessary to visit the gynecologist for the second time after passing the initial stage of medical examination? According to experts, it is not necessary to repeat the examination passed if no pathologies were detected during the analysis of the tests.

Second phase

A patient who has passed the initial stage of examination of the adult population is assigned an additional examination if any violations in the functioning of systems and organs are detected. What is included in the medical examination at the second stage? It will be carried out by specialists of a narrow profile, and re-testing will also be required to confirm or refute the preliminary diagnosis. The patient is offered a list of free services, including:

  • consultations of various specialists: gynecologist, urologist, surgeon, otolaryngologist;
  • additional instrumental or laboratory studies.

Each patient who has passed medical examination and examination by a therapist receives a "Health Card", which should include all the data.

How to prepare for the medical examination?

Visits to doctors and procedures included in the bypass list must be scheduled for the morning. The subject must arrive at the medical facility on an empty stomach. Preliminary it is not recommended to play sports (charging, jogging). It is worth taking care of taking samples of urine and feces for analysis in advance. It is recommended to use special containers for this, which are sold in any pharmacy.

What rules should be followed when collecting material? Urine should be collected 2 to 3 seconds after the start of urination. 24 hours before collecting the material, you can not eat fresh food that can change its color. These include beets, carrots. It is forbidden to take diuretics. They can have a strong influence on individual characteristics.

The collected urine must be delivered to the clinic within 1.5 hours. It must be stored at a positive temperature. Scheduled medical examination provides for the re-surrender of urine if it was delivered later than the specified period or was exposed to low temperature indicators.

How long will it take to complete the inspection?

The list of examinations included in the first stage requires, as mentioned earlier, two visits to the medical facility. It takes from 2 to 6 hours - it all depends on the age of the subject and the number of doctors he must visit.

The second time the patient comes in 1-6 days, when all the tests are ready. During this visit, the therapist conducts a final examination and summarizes. In case of detection of chronic pathologies of a non-infectious nature or other serious diseases, a study of the issues that have arisen is carried out. The duration of the additional examination depends on the number of necessary tests and examinations.

So, general medical examination is required for the timely diagnosis and treatment of various diseases. Such a system allows you to control the development of pathologies in the population. An annual examination helps to identify the disease in the early stages and take the necessary measures. It is also important that comprehensive measures are aimed at helping the least protected segments of the population. In particular, prophylactic medical examination of pensioners, invalids, orphans is offered.

Content

Free clinical examination started in Russia in 2013. Thanks to the federal program, you can undergo a medical examination, and then receive a Health Passport. It indicates the results of the diagnostics carried out and contains recommendations regarding lifestyle and maintaining health.

How to pass a full medical examination for free in 2019

Clinical examination is a comprehensive diagnostics for the detection of chronic pathologies at their initial stage.

The examination is carried out in order to prevent the progression of the disease, to prevent the risks of occupational diseases, to prescribe topical treatment.

For all age groups, the likelihood of developing certain pathologies is inherent. Based on this, a list of narrow and general specialists is compiled, who must undergo a medical examination for citizens who are subject to medical examination. The main attention is paid to the work of the cardiovascular, endocrine and pulmonary systems, as well as tumors and neoplasms.

What years of birth are

In 2019, citizens who are 21, 24, 27, 30, 33, 36, 39, 42, 45, 48, 51, 54, 55 years of age or older are eligible to undergo a medical examination. According to this information, persons born before 1955 or in:

  • 1998;
  • 1995;
  • 1992;
  • 1989;
  • 1986;
  • 1983;
  • 1980;
  • 1977;
  • 1974;
  • 1971;
  • 1968;
  • 1965;
  • 1962.

Free medical examination of the adult population is carried out every three years, but persons of pre-retirement age (5 years before the right to a pension arises) can undergo it annually. Pensioners have the same right.

Minors undergo extended medical examination at 1, 3, 6, 7.10, 14, 15, 16, 17 years. This is due to the fact that age-related diseases are fixed at this age. Based on this, in 2019, children who were born in:

  • 2018;
  • 2017;
  • 2016;
  • 2013;
  • 2012;
  • 2009;
  • 2004;
  • 2003;
  • 2002.

State Medical Examination Program 2019

Check health in the clinic at the place of registration or residence. Detailed information can be obtained from the therapist or at the reception. Taking into account the age and the presence of pathologies, a certain list of tests and examinations by doctors is formed for each person. Medical examination is exclusively voluntary, therefore it can be waived.

Outpatient clinic includes:

  • visiting a therapist
  • medical examination by narrow specialists;
  • lab tests;
  • instrumental methods of examination (fluorography, ultrasound).

The principles of the program remain unchanged and do not differ from previous years, but since 2019 some changes have been made.

According to the new provisions, the employer is obliged to give the employee a day off from work with the preservation of earnings for a scheduled inspection.

The day intended for medical examination is determined by the management of each clinic independently. The schedule is transferred to the enterprise or organization where the person works. The manager will independently be obliged to notify employees of the set date.


Goals

The main task of conducting free medical examination is to improve human health, increase its efficiency, increase life expectancy, and minimize the risk of death. Basic goals:

  • diagnose non-communicable chronic diseases;
  • give preventive advice;
  • establish groups for dispensary observation of the adult population;
  • identify major risk factors;
  • prescribe treatment.

The scheduled inspection is divided into two stages. Initially, the patient is examined for the presence of non-communicable chronic diseases (diabetes mellitus, diseases of the internal organs, cancer). The main goal of the stage is the diagnosis of risks that may threaten human health, the identification of the use of psychotropic or narcotic drugs.

Between the first and second stages, laboratory tests are carried out. The list is determined based on the lifestyle of a citizen, and is entered in the dispensary sheet. If diseases are detected, the person is sent to the second stage, where he is examined by narrow specialists (urologist, otolaryngologist, mammologist, endocrinologist), and passes extended tests.

Additional medical examinations

For certain categories of the population, additional screening studies are carried out. They are necessary to confirm or refute the possibility of having an ailment characteristic of a certain age. Surveys are assigned at the first stage:

  • born before 1984 - electrocardiogram;
  • born before 1978 - intraocular pressure;
  • born before 1969 – consultation and examination by a neurologist;
  • women - examination by a gynecologist with the obligatory delivery of a smear for analysis.

Which doctors pass in 2019

The main attention is paid to the early diagnosis of diseases that threaten the life or health of citizens. You should visit the following doctors:

  • therapist;
  • gynecologist;
  • neurologist;
  • ophthalmologist;
  • surgeon.

In the course of medical examination of the adult population

Depending on age, medical examination 2019 has its own characteristics:

  • Men over 45 and women over 55 undergo a duplex scan of the brachycephalic arteries, through which the brain is supplied with blood. An examination is prescribed if this category has high blood pressure (from 140/90 mm Hg), cholesterol (above 5 mmol / l) and overweight (determined by the therapist).
  • During the primary medical examination, an electrocardiogram is prescribed for men under 35 and women under 55 years of age. For persons older than the specified age, an ECG of the heart is performed at each subsequent dispensary observation.
  • Women after 30 years of age need to take a smear from the surface of the cervix.
  • Men, upon reaching the age of 51, do a blood test to fix the indicator of prostate-specific antigen.
  • Colonoscopy is performed for everyone with suspected oncological diseases of the colon or if the patient has a hereditary predisposition and (or) occult blood is detected in the analysis of feces.

Medical examination of pensioners

On the day of medical examination, a number of indicators are recorded for citizens of pre-retirement and retirement age in order to calculate the body mass index. In case of obesity or excessive thinness, a consultative conversation is held. During the dispensary observation, blood and intraocular pressure are measured, the level of glucose and total cholesterol, the likelihood of developing cardiovascular pathologies are determined.

Pensioners do a cardiogram and fluorography. Women under the age of 60 undergo a gynecologist, and before the age of 70 they also undergo a mammological examination (every 2 years). Indispensable is the analysis of feces for occult blood (every 2 years). Citizens who have crossed the 60-year mark measure intraocular pressure.

Clinical examination of children

The first examination after discharge from the hospital takes place when the newborn is one month old. It includes ultrasound, examination by an ophthalmologist, neurologist and orthopedist. Six months after the birth of the baby, they show the cardiologist, laura and ophthalmologist. Further, based on the age of the prophylactic, the list of specialists and examinations carried out during the prophylactic examination of children will vary:

  • 1–3 years. In addition to the therapist, the child is examined by a dentist, an ophthalmologist and an orthopedic surgeon. Preventive vaccinations are carried out, general tests are given. Ultrasound of internal organs, ECG can be prescribed.
  • 3–7 years. Additionally, you need to visit a neurologist and a speech therapist.
  • 7–17 years old. Dispensary observation consists in examination by an endocrinologist, dentist, orthopedic surgeon, gynecologist or urologist, gastroenterologist, dermatologist.

The procedure for passing the medical examination

You can undergo medical examination in Moscow at the clinic at the place of residence. If in 2019, based on age, it is not provided, a person has the right to sign up for a medical examination on his own. You need to have an identity card, a compulsory medical insurance policy (OMS) plus SNILS with you. The passage procedure is subject to the following algorithm:

  1. Fill out a questionnaire and consent to medical intervention at the reception or with a therapist.
  2. On the appointed day, come to the district clinic for testing.
  3. Pass the required specialists.
  4. Come to a second appointment with a therapist to assign a health group, conduct a consultation. The specialist will acquaint you with information on the prevention of the development of diseases.
  5. If chronic diseases are detected as a result of examination, go through the second stage of medical examination - consultation and examination by narrow specialists.

Paid time off for medical examination

For working citizens subject to medical examination, the employer is obliged to provide a day off from work every 3 years with the preservation of the workplace and wages.


Until 2019, for a medical examination, you had to take a day off or a vacation day at your own expense.

Scheduled inspection

The therapist gives the patient a dispensary sheet with a list of doctors and tests. A scheduled inspection can take 4-6 hours. After all the tests are ready (this can take up to 6 days), the pensioner must re-appear for an appointment with a therapist.

The doctor will examine the results of a comprehensive examination. In case of health problems or the presence of chronic diseases, he will prescribe an additional examination to the patient, but already with highly specialized specialists. For medical examination, the legislation provides for:

  • 1 day for all employees every 3 years;
  • 2 days annually for people of pre-retirement age or retirees who continue to work.

Screening results and dispensary health groups

Upon completion of the medical examination, everyone is issued a Health Passport, which is a document confirming the passage of a medical examination. If necessary, it is provided to the employer to record the fact of a preventive examination. Schoolchildren, pupils and university students submit a certificate from the therapist to the educational institution.

According to the results of the examination, the therapist classifies a person into one of three groups:

  1. Citizens without chronic diseases and the likelihood for their occurrence.
  2. Persons who do not suffer from chronic diseases, but who are at risk due to the possibility of developing the disease.
  3. People with chronic diseases or the results of their examination are outside the limits of the established indicators.

During the medical examination of children, the pediatrician refers the minor to one of 5 groups:

  1. Completely healthy children who have a high degree of body resistance to infections and diseases.
  2. Children with reduced immunity.
  3. Minors with chronic diseases in remission.
  4. Children with chronic diseases who have a deterioration in health or impaired functioning of internal organs.
  5. Disabled children.
3 days Answer

Why go for medical examination if you feel healthy?

Going to the doctor periodically when nothing is bothering you is the normal behavior of a person who cares about staying healthy as long as possible.

The diseases from which people are now dying are the diseases of civilization. Firstly, these are the risk factors associated with civilization - urbanization, stress, overnutrition, low physical activity, they give rise to all these major diseases. It is these mechanisms that are behind the development of various diseases. In Russia, four types of diseases have been identified from which people most often die: cardiovascular, oncological, bronchopulmonary, and diabetes mellitus. As a result, the question arose of the need to call on citizens to take care of their health, because a healthy population is the national wealth of any country. Recently, the concept of clinical examination has returned to us - this is a system of measures aimed at maintaining the health of the population, preventing the development of diseases, reducing the frequency of exacerbations of chronic diseases, the development of complications, disability, mortality and improving the quality of life.

Medical examination takes place indefinitely and in all regions of the country and is carried out with the informed voluntary consent of a citizen or his legal representative. A citizen has the right to refuse to conduct medical examinations in general, or from certain types of medical interventions included in the scope of medical examinations. But why?

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

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

How often is screening done?

According to the Order of the Ministry of Health of the Russian Federation No. 124n dated March 13, 2019 "On approval of the procedure for conducting a preventive medical examination and clinical examination of certain groups of the adult population", medical examination of the adult population is carried out in two stages starting from 18 to 39 years old inclusive every three years and annually at the age of 40 years and older. In those age periods that do not fall under the medical examination, you can undergo a preventive examination annually.

Where can you get a medical examination?

Citizens undergo a medical examination in a medical organization at the place of residence (attachment), in which they receive primary health care (in a polyclinic, in a center (department) of general medical practice (family medicine), in a medical outpatient clinic, medical unit, etc.). If you decide to undergo a medical examination, remember that during the medical examination, employees have the right to be released from work for 1 working day once every 3 years, while maintaining their workplace and average earnings.

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.

Each person who would like to undergo a medical examination must contact the medical organization at the place of attachment.

At the first visit, your height, weight, waist circumference, blood pressure, cholesterol and glucose levels (by the express method) are measured, and the total cardiovascular risk is assessed. Here are two documents:

1. Informed voluntary consent to medical intervention.
2. Questionnaire for the identification of chronic non-communicable diseases.

A necessary precondition for conducting a preventive medical examination and medical examination is the giving of an informed voluntary consent of a citizen (his legal representative) to medical intervention in compliance with the requirements established by Article 20 of Federal Law No. 323-FZ.

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

What documents are required for medical examination?

Every citizen heading for medical examination or medical examination must have a passport and a compulsory medical insurance policy.

When conducting a preventive medical examination and medical examination, the results of previously conducted (no later than one year) medical examinations, medical examinations, confirmed by the citizen’s medical documents, may be taken into account, except for cases of identifying symptoms and syndromes of diseases that indicate the presence of medical indications for repeated research and other medical measures. as part of a preventive medical examination and medical examination.

What are the stages of dispensary?

The list of doctors and examinations will be individual: it all depends on your state of health, age, the presence of already diagnosed chronic diseases, etc.

The dispensary is carried out in two stages.

The first stage of medical examination (screening) is carried out in order to identify in citizens signs of chronic non-communicable diseases, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor's prescription, as well as determining medical indications for additional examinations and examinations by specialist doctors to clarify the diagnosis of the disease (state) at the second stage of clinical examination. Cancer screening, personified by gender and age, has been introduced into the program. They are carried out in those groups where they confirm the greatest efficiency.

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

The second stage of medical examination is carried out for the purpose of additional examination and clarification of the diagnosis of the disease (condition), in-depth preventive counseling and includes conducting according to the indications determined at the first stage.

What happens if during the medical examination a patient is diagnosed with deviations in health?

After all the studies and consultations of specialists, the patient goes to see a therapist. Based on the results of the medical examination, for planning the tactics of his medical supervision, the health group is determined:

    I health group - citizens who have not been diagnosed with chronic non-communicable diseases, there are no 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).

    Health group II - citizens who do not have chronic non-communicable diseases, but have risk factors for developing 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 or more, 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 a dispensary monitoring for other diseases (conditions).

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

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

    If during the prophylactic medical examination indications are found for additional examinations that are not included in its program, they are prescribed in accordance with the procedures for providing medical care according to the profile of the identified or suspected pathology. And with the modern three-level organization of medical care, the continuity between polyclinics, hospitals and centers for the provision of high-tech medical care makes it possible to diagnose the patient as soon as possible and provide all the necessary assistance, including high-tech.

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

What is dispensary observation

Dispensary observation is a dynamic monitoring, including the necessary examination, of the health of persons suffering from chronic diseases, functional disorders, other conditions, in order to timely identify, prevent complications, exacerbations of diseases, other pathological conditions, their prevention and medical rehabilitation of these persons carried out in accordance with the procedure established by the authorized federal executive body

Dispensary supervision includes:

    1) assessment of the state of a citizen, collection of complaints and anamnesis, examination;

    2) appointment and evaluation of laboratory and instrumental studies;

    3) establishing or clarifying the diagnosis of the disease (condition);

    4) conducting brief preventive counseling;

    5) the appointment of preventive, therapeutic and rehabilitation measures for medical reasons, including the referral of a citizen to a medical organization providing specialized (high-tech) medical care, to a sanatorium-and-spa treatment, to a department (office) of medical prevention or a health center for in-depth individual preventive counseling and/or group preventive counseling (patient school);

    6) explaining to a citizen with a high risk of developing a life-threatening disease (condition) or its complication, as well as to persons living with him, the rules of action in case of their development and the need to promptly call an ambulance.

The grounds for termination of dispensary observation are:

  • recovery or achievement of stable compensation of physiological functions after an acute illness (condition, including trauma, poisoning);
  • achieving stable compensation of physiological functions or stable remission of a chronic disease (condition);
  • elimination (correction) of risk factors and reduction of the risk of developing chronic non-communicable diseases and their complications to a moderate or low level.

What document confirms the medical examination?

On the basis of information about the passage of a preventive medical examination and (or) clinical examination by a citizen, a medical examination registration card is filled out.

The results of appointments (examinations, consultations) by medical workers, studies and other medical interventions included in the scope of a preventive medical examination and clinical examination are entered in the medical record of a patient receiving medical care on an outpatient basis, marked "Preventive medical examination" or "Prophylactic medical examination".

Clinical examination allows you to improve health, identify the disease as early as possible, treat the disease with the greatest success.

Take care of your health and it will thank you!