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Since 2013, Russia has been implementing a large-scale program of periodic medical examination of the population over 21 years of age. In 2019, the next stage of this program will take place, in which millions of Russians will take part. The main goal of widespread medical examination is the early detection of health problems and chronic diseases at the beginning of their development.

Such constant monitoring helps reduce possible risks and significantly reduce the mortality rate, especially at a young age. A by-product of such mass monitoring is the detection of the most common health problems in different age groups and the collection of statistics based on the data obtained.

Doctors have found that the occurrence of various health pathologies and exacerbation of chronic diseases are characteristic of certain age groups of people. If you undergo medical examinations and tests during critical years, you can identify emerging pathogenic processes in time and begin treatment, avoiding serious problems and death.

A similar practice of routine examination exists in many countries of the world, and in the Russian Federation it began to be implemented back in the days of the USSR. In 1968, the World Health Organization developed special rules for screening (mass examination), which are still in effect today. The main ones are availability, frequency and necessary treatment.

Every three years, you need to spend a few days visiting specialized specialists to make sure that there are no significant malfunctions in the functioning of internal organs or to begin treatment for newly identified ones in a timely manner. The procedure is not compulsory for all groups of the adult population, so many still do not know anything about this treatment and prophylactic measure and do not undergo it on time.

The years of birth subject to scheduled medical examination in 2019 are shown in the table below.

All persons over 18 years of age are considered adults and from this age can be screened every three years. This time interval is optimal for monitoring the general health of a person. In the early stages, many serious diseases are asymptomatic and cannot be detected independently by changes in well-being. But if you are examined for the purpose of prevention, the results of tests and other studies will promptly indicate the hotbeds of emerging problems.

Thanks to a thoughtful approach to clinical examination, it is possible to detect such dangerous ailments as diabetes, oncological processes, pathologies of the cardiovascular system, respiratory tract, disorders in the circulatory system, brain activity and many others in the initial phases.

In addition, every 2 years you can undergo a preventive examination, which is an abbreviated screening program. Veterans of the Great Patriotic War and children are examined annually.

Statistics from recent years have shown that medical examination is already bringing a positive effect - early mortality and the number of people receiving disability as a result of common diseases have decreased.

Caring for the health of citizens is a priority direction for the development of the Russian state, therefore the population must be conscious and not refuse to visit medical institutions in a timely manner.

Which years of birth are subject to clinical examination in 2019?

As we found out just above, for adults the screening procedure is carried out every three years starting at the age of 21. Thus, people with the following birth years are eligible for medical examination in 2019:

1998
1995
1992
1989
1986
1983
1980
1977
1974th,
1971
1968
1965
1962
1959
1956th,
1953rd,
1950th,
1947th,
1944th,
1941st,
1938th,
1935th,
1932nd,
1929th,
1926th,
1923rd,
1920th,
1917, etc.

Medical examination is a voluntary procedure. If you don’t want to go through it, that’s your right. However, it makes sense to take the opportunity to check your health by undergoing basic tests and being examined at a clinic.

If your year of birth is not on the list, you can still undergo medical examination in 2019. True, most likely, the examination will not be carried out as deeply as is done for those whose health is checked according to the plan.

What is included in the medical examination

What other most important studies, including expensive ones, can be completed free of charge as part of a medical examination next year:

- duplex scanning of the brachycephalic arteries: this is an expensive study of the main arteries through which our brain is supplied with blood. This examination is prescribed for men over 45 years of age and women over 55 years of age if they simultaneously have three risk factors: high blood pressure (140/90 mm Hg and above), cholesterol (above 5 mmol/l) and excess body weight (determined by doctor upon examination, measuring height, weight and waist circumference);

- electrocardiography: prescribed for men over 35 years of age, women 45 years of age and older at each medical examination, and for women under 45 years of age and men under 35 - at the first medical examination;

- smear from the surface of the cervix - for women from 30 to 60 years old: this important study allows you to detect a precancerous condition of the cervix and save the woman, avoiding removal of the uterus;

- colonoscopy - examination of the intestines, prescribed for suspected colorectal cancer. As a rule, if there is a hereditary predisposition and/or occult blood is detected in stool tests.

Features of the first stage

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

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

Regardless of your health...

Regular medical examination is necessary for all people, regardless of health status, says Sergei BOYTSOV, chief freelance specialist in preventive medicine at the Russian Ministry of Health. - Even if a person considers himself healthy, during medical examination he is often diagnosed with dangerous non-infectious diseases, the treatment of which is most effective at an early stage. The state provides for such care for the health of the population in the form of medical examination: tests, examination with equipment, consultations. This will help prevent or identify diseases, adjust lifestyle or begin treatment to prevent further development of the disease. Moreover, all this is at the expense of the state, under the compulsory medical insurance policy. The same examinations in paid medical centers will cost a person, as they say, a pretty penny, and more than one.

And indeed it is. Although almost every third of the Russians surveyed believes that “dispensary examinations are often carried out formally and give little benefit,” the number of people wishing to undergo absolutely free preventive examinations at their place of residence and receive consultations with doctors is growing. But according to surveys, there are also a lot of complaints: almost every fourth person complains about being in line; that it is impossible to undergo a medical examination in one day - every sixth.

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

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

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

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

All citizens over 38 years of age are required to have their intraocular pressure measured by an ophthalmologist, have their eyes checked for glaucoma, etc. And also be checked for general dehydration and blood pressure levels. Those aged 21 years and older can take a voluntary, anonymous and free HIV test.

The second stage of clinical examination excludes determination of the blood lipid spectrum, determination of the concentration of glycated hemoglobin in the blood, and esophagogastroduodenoscopy (examination of the mucous membranes of organs that are part of the gastrointestinal tract).

Deputies of the Moscow City Duma spoke out against the exclusion of traditional types of tests at the first stage of clinical examination. And they even made a proposal to give Moscow the right to independently determine the list of studies and consultations during clinical examination, as our newspaper wrote about. How it will be in practice, time will tell.

Men can't get away either

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

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

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

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

Men can't get away now either. The level of PSA (prostate-specific antigen) in the blood, which can indirectly indicate cancer, will be determined for all men at 45 years of age and at 51 years of age. And not just selectively, but for medical reasons.

As experts explain, based on the results of the first stage, doctors must identify possible chronic non-infectious diseases (cardiovascular, oncological, bronchopulmonary and diabetes mellitus) among those who come for an appointment, as well as their risk factors. And if someone is found to have a high risk of heart problems, obesity, or high cholesterol, specialists should conduct individual consultations. Especially if the person is over 70.

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

At the second stage: To clarify a person’s health status, doctors must offer not only additional methods of various studies, but also consultations with specialized specialists. In addition, duplex scanning of the brachycephalic arteries, colonoscopy, and spirometry should be performed. And based on the results, also consult the patient with a urologist, coloproctologist, or surgeon. Thanks to such an extensive set of studies, doctors are able to identify chronic non-infectious diseases at an early stage and reduce the likelihood of disability and premature death. Doctors include cardiac ischemia, neoplasms, endocrine diseases, and chronic lung diseases as killer diseases. By the way, this year doctors are recommended to pay special attention to any tumors and neoplasms.

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

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

Workers are required to be released for medical examination. In law

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

Workers today have such a chance. According to the law “On the fundamentals of protecting the health of citizens in the Russian Federation” (Article 24 of the Federal Law of the Russian Federation dated November 21, 2011 No. 323-FZ), employers are obliged to provide conditions for employees to undergo medical examinations and also freely send them to doctors.

Large cities now have electronic appointments with doctors. You can also fill out a medical examination form in advance. People are now reminded of the need to undergo a medical examination by phone or invited via SMS. True, only the first signs of such mobile services have emerged.

Experts are convinced that personal responsibility for one’s own health is no less, and perhaps even more important. Yes, medical examination is voluntary. No one will force anyone to go to the doctor for preventive examinations. But, according to experts, it would be a sin not to take advantage of the opportunity to be examined “through and through” for free once every three years.

AND NOW - ATTENTION!

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

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

Where to contact?

As explained by the Ministry of Health of the Russian Federation, to undergo medical examination, you must come to the medical organization at your place of residence (attachment), to your local physician (paramedic) or to the office (department) of medical prevention. If you have any questions, contact a representative of your medical insurance organization (the telephone number is indicated in the compulsory medical insurance policy). And doctors advise visiting doctors to start in the morning and come on an empty stomach in order to get tested and not reschedule the visit until the next day. It is also necessary to avoid intense physical activity for several hours before the examination.

What documents are needed?

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

Once every three years, all adult Russians have the right to undergo a free medical examination. It is carried out in order to identify serious diseases in the early stages, which in an advanced state can lead to disability or death. In order to be examined in a timely manner, you need to know how clinical examination is carried out, which years are currently covered by it, and what result it should lead to. Now it will be easier for working citizens to monitor their health. Legislators have provided additional days off for them, which they can use for only one purpose - to undergo a medical examination at a medical institution.

Changes to the Labor Code and other innovations

The procedure according to which medical examinations are organized was significantly changed in 2018, thanks to two legislative innovations.

On October 3, 2018, the Russian President signed Federal Law No. 353-FZ on amendments to the Labor Code. A new article 185.1 has been added to it. It establishes guarantees for workers who wish to undergo medical examination. Now, once every three years, the company’s management is obliged to give them a day off, preserving their jobs and average daily earnings for absent employees.

Retired workers, as well as personnel of pre-retirement age (those who have no more than 5 years left before retirement) will be able to use this preference much more often - they are allocated 2 working days annually to undergo medical examination.

Article 185.1 of the Labor Code will come into force in January next year, that is, new labor guarantees apply to employees who are expected to undergo a medical examination in 2019 and undergo it in subsequent years. Days off for medical examination are provided by agreement with management (by written request), and not on any day convenient for the employee.

In Art. 185.1 of the Labor Code contains an important clause: workers are released from work only if they undergo medical examination in the manner prescribed by law. In this regard, it is necessary to take into account that in January 2018, a new Order of the Ministry of Health of the Russian Federation No. 869n dated October 26, 2017 came into force. The document defines the procedure for conducting medical examinations for certain categories of the adult population, which must be followed in order to have the right to additional days off.

How to get a medical examination

Those wishing to undergo medical examination should contact the clinic at their place of residence:

or see a therapist

or see a general practitioner.

You need to take with you to your appointment:

• insurance policy;

  patient's medical record (if the patient had it).

Some clinics also require SNILS, although lawyers and officials have repeatedly pointed out that this requirement is illegal. This document is necessary for pension accounting, to which medical examination of the population has nothing to do. However, in order to avoid a conflict situation, when going to the doctor, it is better to take SNILS.

At an appointment with a doctor, a citizen will be asked to sign a voluntary consent to the upcoming medical intervention. The patient has the right to refuse certain types of them.

The doctor writes out a referral to specialists and to undergo certain tests, after which the citizen begins to be examined. The identified information about his state of health is entered into the medical record with a special note: “Medical examination.” This is the first stage of a medical examination, the main goal of which is to identify the first signs of chronic diseases and identify risk factors.

They proceed to the second stage if the results obtained at the 1st stage required additional research to clarify the diagnosis. For example, if a woman has undergone medical examination and mammography reveals pathological changes in the breasts, she is sent for examination to an obstetrician-gynecologist who can determine their causes and prescribe treatment.

If a patient is denied medical examination at the clinic, or problems arise during its implementation, he has the right to complain:

to the administration of the medical institution;

to the insurance company (its contacts are indicated on the policy);

to the regional health department;

to the city/territorial/regional specialized committee overseeing healthcare.

Citizens undergo medical examinations not in the general queue, but at a specially designated time.

Clinical examination: which years of birth fall in 2018/2019.

Russians undergo free medical examinations according to a certain schedule, depending on the year they were born. The interval is three years. A citizen has the right to undergo the first medical examination at the age of 21, that is, three years after reaching adulthood.

For example, a medical examination is currently underway for 2018 - the years of birth are starting from 1997, with a 3-year interval in a decreasing direction: 1994, 1991, 1988, etc.

More detailed and visual information about the years of birth participating in the medical examination of the population in 2018-2019 is presented in the table.

Simply put, those whose age this year is divisible by 3 (regardless of whether their birthday has already passed or not) are expected to undergo a medical examination. For example, a citizen born in 1976, who will turn 42 years old on December 31, 2018, has the right to undergo medical examination in any month of 2018.

In addition to events carried out every three years, for the purpose of early diagnosis of cancer, once every 2 years:

women aged 51 to 69 years are entitled to undergo mammography,

Citizens aged 49 to 73 years undergo a stool test for occult blood.

Regardless of age, the following have the right to annual medical examination:

disabled people of WWII and combat,

former child prisoners of concentration camps with disabilities

disabled people who have the sign “Resident of besieged Leningrad”.

A large-scale medical examination of a large number of citizens in healthcare is called medical examination. It is carried out with the aim of identifying various diseases throughout the country and preventing their development. Such an event consists of visiting doctors of various specialties and a detailed examination of the whole body.

Medical examination of the adult population

This procedure can be completed by any citizen of the Russian Federation who has reached twenty years of age, regardless of whether he is employed or unemployed. A portion of the population is eligible to undergo a thorough examination every year. According to the decree of the Ministry of Health, the procedure for checking the body is free, all costs are covered by the compulsory medical insurance policy. In 2018, it applies to those born in the years listed in the law. Its goal is to identify diseases at an early stage. As you know, many diseases await each of us, regardless of the type of work. In 2013, medical examination was included in compulsory health insurance. From now on, this is a free service and can be completed in any state hospital in Russia. In addition, more and more private medical institutions are now joining this program, completely voluntarily.

Medical examination tasks

A broad survey of the population is carried out to:

• identify risk factors that can lead to chronic non-communicable diseases;
• detect serious diseases at an early stage;
• adjust risk factors for chronic diseases.

How to get tested

To undergo a body check, you must come to the medical institution at your place of study or residence and present only your passport. This is quite enough for you to be prescribed an examination according to your age. The frequency of this procedure is once every three years. Medical examinations are carried out by doctors who have completed special advanced training courses.

What years of birth are subject to verification?

According to the order of the Ministry of Health, those born in 1997 are tested. In addition, people whose year of birth ends in: 19,22,25,28,31,34,37,40,43,46,49,52,55,58,61,64,67 must undergo a body check. 70,73,76,79,82,85,88,91,94. To figure out whether your age is suitable to participate in medical examination, you need to divide your age by three. If the result is clear, then you need to undergo examination.

• those suffering from acute forms of heart disease;
• suffering from diabetes mellitus in any form;
• with chronic lung diseases.

What does it include?

The list of necessary doctors and tests is compiled personally for each patient. However, it is almost the same for people who do not have severe illness. Many examinations that patients underwent throughout the year are counted automatically. There is no need to repeat the analysis.

Typically, clinical examination takes place in stages:

• at the first stage, patients undergo the necessary tests and are checked for alcohol and drug abuse;
• the second stage includes visiting the necessary specialists, the list of which is determined by the doctor after reviewing the results of the tests.

When medical examination begins you should not:

• within a few days, eat onions, peppers, cucumbers, cauliflower, apples and heavy foods such as fried meat, smoked meats, etc.;
• take various laxatives;
• have breakfast on the day of the examination;
• engage in physical exercise.

The second stage is planned specifically for each patient separately. The local doctor responsible for medical examination decides which doctors need to be visited.

Which doctors and examination tests are required?

Usually all citizens are first sent to a therapist. This applies to all ages. Next, a referral to a neurologist is mandatory. In addition, representatives of the fair half are required to be sent to a gynecologist, who takes a smear for cytological examination. This is done to determine the risk of uterine cancer. Starting at the age of thirty-nine, women are sent for a mammography examination to assess the condition of the female mammary glands.

Men over 36 years of age must undergo an ECG. All patients over thirty-nine years of age should undergo an abdominal ultrasound. This is done to detect stones and tumors.

What doctors and examination tests are carried out can also be seen from the table:

A comprehensive examination of the body helps to identify the risk of developing a particular disease. After completion of the clinical examination, all patients are divided into three groups:

• relatively healthy;
• those at high risk of disease;
• sick.

Based on the results of the medical examination, patients are given a health passport. It contains the conclusions of all doctors and contains recommendations that should be followed to prevent the occurrence or development of diseases.

The verification usually takes about six days. Employers should not oppose the examination and understand that it is better to have healthy employees rather than those who are constantly on sick leave.

According to Russian legislation, medical examination is a voluntary event. A citizen of the Russian Federation can either use this right or not. Doctors recommend doing it systematically. If you don't complain about anything, it doesn't mean you're completely healthy.

Why undergo medical examination if you feel healthy?

Periodically going to the doctor when nothing else bothers you is the normal behavior of a person who cares about staying healthy for as long as possible.

The diseases from which people are dying now are diseases of civilization. Firstly, these are risk factors associated with civilization - urbanization, stress, excess nutrition, 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. As a result, the question of the need to urge citizens to take care of their health has become acute, because a healthy population is the national wealth of any country. Recently, the concept of medical examination has returned to us - this is a system of measures aimed at preserving 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.

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

Regular medical examination is necessary, regardless of how you feel. Even if a person considers himself healthy, during medical examination he is often diagnosed with chronic non-infectious diseases, the treatment of which is most effective at an early stage.

Medical examination will allow you to maintain and improve your health, and, if necessary, conduct additional examination and treatment in a timely manner. Consultations with doctors and test results will help you not only learn about your health, but also receive the necessary recommendations on the basics of a healthy lifestyle or on identified risk factors.

How often are medical examinations carried out?

According to Order of the Ministry of Health of the Russian Federation No. 124n dated March 13, 2019 “On approval of the procedure for conducting preventive medical examination and medical 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 are not subject to medical examination, you can undergo a preventive examination annually.

Where can I get a medical examination?

Citizens undergo medical examination in a medical organization at their place of residence (attachment), in which they receive primary health care (in a clinic, 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 job and average earnings.

Workers of pre-retirement age (within 5 years before retirement age) and pensioners receiving an old-age or long-service 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 agree with management on the days of medical examination and write an application for release from work.

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

On your first visit, your height, weight, waist circumference, blood pressure, cholesterol and glucose levels are measured (using the express method), and your total cardiovascular risk is assessed. Here you will need to fill out two documents:

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

A necessary precondition for conducting a preventive medical examination and medical examination is the giving of informed voluntary consent of the 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 a preventive medical examination and (or) medical examination in general or certain types of medical interventions included in the scope of the preventive medical examination and (or) medical examination.

What documents are required to undergo medical examination?

Every citizen going for a 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 and medical examinations, confirmed by the citizen’s medical documents, may be taken into account, with the exception of cases of identifying symptoms and syndromes of diseases indicating the presence of medical indications for repeated examinations and other medical measures. as part of preventive medical examination and medical examination.

What are the stages of medical examination?

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

Clinical examination is carried out in two stages.

The first stage of medical examination (screening) is carried out in order to identify signs of chronic non-communicable diseases in citizens, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor’s prescription, as well as to determine medical indications for additional examinations and examinations by medical specialists to clarify the diagnosis of the disease (conditions) at the second stage of medical examination. The program includes cancer screening, personalized by gender and age. They are carried out in those groups where they confirm the greatest effectiveness.

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), conducting in-depth preventive consultation and includes carrying out according to the indications determined at the first stage.

What happens if during medical examination a patient’s health abnormalities are discovered?

After all the research and consultations with specialists, the patient goes to see a therapist. Based on the results of medical examination to plan the tactics of his medical observation, the health group is determined:

Health group I - citizens who do not have established chronic non-infectious diseases, do not have risk factors for the development of such diseases, or have the indicated risk factors with low or average absolute cardiovascular risk and who do not need clinical observation for other diseases (conditions).

Health group II - citizens who have not been diagnosed with chronic non-infectious diseases, but have risk factors for the development of such diseases with a high or very high absolute cardiovascular risk, as well as citizens who have been diagnosed with 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 consuming narcotic drugs and psychotropic substances without a doctor’s prescription, and who do not need a dispensary observation for other diseases (conditions).

Health group IIIa - citizens with chronic non-infectious diseases that require 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;

Health group IIIb - citizens who do not have chronic non-infectious 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 medical examination there are indications for additional examinations 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, continuity between clinics, hospitals and centers for the provision of medical care makes it possible to diagnose the patient in the shortest possible time and provide all the necessary assistance, including high-tech.

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

What is clinical observation

Dispensary observation is a dynamic observation, including the necessary examination, of the health status of persons suffering from chronic diseases, functional disorders, and other conditions, for the purpose of timely detection, prevention of complications, exacerbations of diseases, other pathological conditions, their prevention and implementation of medical rehabilitation of these persons, carried out in the manner established by the authorized federal executive body

Dispensary observation includes:

1) assessment of the citizen’s condition, collection of complaints and medical history, examination;

2) assignment and evaluation of laboratory and instrumental studies;

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

4) conducting brief preventive counseling;

5) appointment of preventive, therapeutic and rehabilitation measures for medical reasons, including sending a citizen to a medical organization providing specialized (high-tech) medical care, for sanatorium-resort 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 complications, as well as to persons living with him, the rules of action in the event of their development and the need to timely 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 injury, poisoning);
• achieving stable compensation of physiological functions or stable remission of a chronic disease (condition);
• elimination (correction) of risk factors and reducing the risk of developing chronic non-communicable diseases and their complications to a moderate or low level.

What document confirms the completion of medical examination?

Based on information about the citizen undergoing a preventive medical examination and (or) medical examination, a medical examination record card is filled out.

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

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

Take care of your health and it will thank you!