What is included in a general medical examination? What is medical examination

Schedule a medical examination

Schedule a medical examination (preventive medical examination)

1. You can undergo medical examination:

2. You can undergo a preventive medical examination at the ages of 19, 20, 22, 23, 25, 26, 28, 29, 31, 32, 34, 35, 37 and 38 years old

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Where can I get a medical examination (preventive medical examination)

1. At the clinic to which you are assigned (weekdays from 8:00 to 20:00, on weekends according to the clinic’s schedule;

2. In the “Healthy Moscow” pavilions in the capital’s parks (daily from 8:00 to 22:00).

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What examinations can be taken at the Healthy Moscow pavilion?

Questionnaire (survey) in electronic form;

Anthropometry (measurement of height, body weight, waist circumference);

Calculation of body mass index;

Measurement blood pressure on peripheral arteries;

Electrocardiography at rest;

Measuring intraocular pressure;

Determination of the level of total cholesterol in the blood using the express method;

Determination of fasting blood glucose levels using the express method;

Advanced blood test;

Determination of prostate-specific antigen (PSA) in the blood of men aged 45,50, 55, 60, 64 years;

Stool examination occult blood immunochemical method

Fluorography*

Determination of relative/absolute cardiovascular risk

Examination and brief individual preventive consultation with a general practitioner;

Mobile fluorographs work on weekends according to a special schedule.

In the clinic at the place of attachment, the following examinations are carried out in accordance with gender and age:

Mammography;

Midwife examination;

Cytological examination of the cervical smear;

• - esophagogastroduodenoscopy

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Get a preventive medical examination

Preventive medical examination – this is a complex medical examinations, carried out for the purpose of early (timely) identification of conditions, diseases and risk factors for their development, as well as for the purpose of determining health groups and developing recommendations for patients.

Preventive medical examination includes:

survey of citizens aged 18 years and older;

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

measurement of blood pressure in peripheral arteries for citizens aged 18 years and older;

study of total cholesterol levels in the blood for citizens aged 18 years and older;

determination of fasting blood glucose levels for citizens aged 18 years and older;

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

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

fluorography of the lungs or x-ray of the lungs for citizens aged 18 years and older once every 2 years;

electrocardiography at rest during the first preventive medical examination, then at the age of 35 years and older;

measurement of intraocular pressure during the first preventive medical examination, then at the age of 40 years and older;

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

reception (examination) based on the results of a preventive medical examination, including an examination to identify visual and other localizations of cancer, including examination skin, mucous lips and oral cavity, palpation thyroid gland, lymph nodes, a paramedic at a paramedic health center or a paramedic-obstetric station, a general practitioner or a doctor for medical prevention in a department (office) medical prevention or health center.

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Complete the first stage of medical examination

First stage clinical examination is carried out in order to identify signs of chronic diseases in citizens non-communicable diseases, risk factors for their development, as well as determining indications for additional examinations and examinations by medical specialists to clarify the diagnosis of the disease (condition) at the second stage.

The first stage of medical examination includes:

1. Preventive medical examination:

2. Screening for early detection oncological diseases:

Examination of feces for occult blood (once every 2 years from 40 to 64 years of age, once a year from 65 to 75 years of age;

Esophagogastroduodenoscopy at 45 years old;

For women:

Examination by a paramedic (midwife) (from 18 to 39 years old);

Taking a smear from the cervix, cytological examination of a smear from the cervix once every 3 years at the age of 18 to 64 years;

Mammography (once every 2 years between the ages of 40 and 75)

For men:

• Determination of prostate-specific antigen in the blood of men aged 45, 50, 55, 60 and 64 years;

3. Brief preventive consultation;

4. General analysis blood (from 40 years and older);

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If necessary, you will be referred to the second stage of medical examination for the purpose of additional examination

The second stage of clinical examination is carried out with the aim of additional examination and clarifying the diagnosis of the disease (condition) if indicated based on the results of the first stage and includes:

examination (consultation) by a neurologist;

duplex scanning brachycephalic arteries (for men aged 45 to 72 years inclusive and women aged 54 to 72 years);

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

examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (for citizens aged 40 to 75 years inclusive);

colonoscopy (for citizens in case of suspected malignant neoplasms colon as prescribed by a surgeon or coloproctologist);

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

X-ray of the lungs, computed tomography lungs (for citizens in case of suspected malignant lung tumors as prescribed by a general practitioner);

spirometry;

examination (consultation) by an otolaryngologist (for citizens aged 65 years and older);

examination (consultation) by an obstetrician-gynecologist (for women aged 18 years and older with diagnosed pathological changes;

examination (consultation) by an ophthalmologist (for citizens aged 40 years and older);

conducting individual or group (school for patients) in-depth preventive counseling in the department (office) of medical prevention (health center) for citizens aged 65 years and older;

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Based on the results of medical examination (preventive medical examination), find out your health group and receive doctor’s recommendations

Health group I – practically healthy and having risk factors with low or moderate total cardiovascular risk. A brief preventative consultation is provided.

Health group II – patients with risk factors for high or very high total cardiovascular risk. In-depth preventive counseling is provided: individual or group (“Patient School”). Dispensary observation in the Health Center or medical prevention department/office is indicated.

Health group III – patients with diseases both detected for the first time during clinical examination and previously established. Dispensary observation by medical specialists is indicated.

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Get a free medical examination or preventive medical examination next year according to your gender and age

This frequency of examinations is sufficient to identify most serious illnesses on early stage development.

Clinical examination (preventive medical examination) is available to every citizen Russian Federation, insured in the compulsory health insurance(who has compulsory medical insurance policy). This applies to all examinations, as well as consultations with specialists.

You can undergo medical examination:

1 time every three years from the age of 18 to 39 years inclusive (at the age of 18, 21, 24, 27, 30, 33, 36, 39);

annually at age 40 and older

2. You can undergo a preventive medical examination at the ages of 19, 20, 22, 23, 25, 26, 28, 29, 31, 32, 34, 35, 37 and 38 years old

Clinical examination (preventive medical examination) is carried out in the department or office of medical prevention in the clinic at the place of attachment. If you are not yet assigned, then this can be done at a time convenient for you during the organization’s opening hours if you have a passport and compulsory medical insurance policy. To do this, you need to present your passport and compulsory medical insurance policy at the reception and fill out an application. It will take 7–10 days to complete the documents.

You can also undergo a medical examination (preventive medical examination) in the Healthy Moscow pavilions in the parks of the capital."

Currently, in Moscow clinics, the first stage of medical examination or preventive examination takes an average of 90 minutes. The duration of the examination depends on the number of tests that need to be completed (according to gender and age).

In the Healthy Moscow pavilions, you can undergo examinations as part of a medical examination (preventive medical examination) for no more than 40–60 minutes.

Based on the results of the medical examination (preventive medical examination), the therapist of the department (office) of medical prevention or the Healthy Moscow pavilion will determine your health group and issue individual recommendations.

Health group I – practically healthy and having risk factors with low or moderate total cardiovascular risk. Brief preventive counseling is provided on improving lifestyle and disease prevention.

Health group II – having risk factors with high or very high total cardiovascular risk. The doctor gives detailed recommendations on how to reduce cardiovascular risk, and can also refer you to the “Patient School”. These are group consultations and training in disease control methods for patients with a common problem. For example, such schools operate in a number of clinics for people suffering from diabetes.

Health group III – patients with diseases both detected for the first time during clinical examination and previously established. Dispensary observation by medical specialists is indicated.

The essence of medical examination (preventive medical examination) is not just to identify diseases or high risk their development, and refer the patient for observation:

Health group II - to the department of medical prevention or the Health Center;

III health group - for dispensary observation by relevant medical specialists.

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, 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 chronic diseases, development of complications, disability, mortality and improved 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 individual species 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 about the basics healthy image life or based 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 can be 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 doctor’s 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 before 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 should contact 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 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 insurance medical insurance Compulsory medical insurance.

When conducting a preventive medical examination and medical examination, the results of previously conducted (no later than one year) may be taken into account. medical examinations, medical examinations, confirmed medical documents citizen, with the exception of cases of identifying symptoms and syndromes of diseases indicating the presence of medical indications for repeated research and other medical events 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 narcotic drugs and psychotropic substances without a doctor’s prescription, as well as determining medical indications for additional examinations and examinations by medical specialists to clarify the diagnosis of the disease (condition) 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 allows for the maximum short time diagnose the patient and provide all necessary help, 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, other conditions, for the purpose of timely detection, prevention of complications, exacerbations of diseases, other pathological conditions, their prevention and implementation medical rehabilitation specified persons, carried out in the manner established by the authorized federal body executive power

Dispensary observation includes:

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

2) appointment and assessment of laboratory and instrumental studies;

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

4) conducting brief preventive counseling;

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

6) explanation to a citizen at high risk of development life-threatening disease (condition) or its complications, as well as 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 physiological functions after the transferred acute illness(conditions, including trauma, 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 medical card patient receiving medical care outpatient setting, 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!

Medical examination is called full examination at medical specialists, in which predisposition to common diseases is identified, and the onset of non-infectious diseases and neoplasms is detected.

It is advisable to undergo medical examination once every three years. It is recommended that children be examined once a year.

So far, medical examinations are being carried out on a voluntary basis, but the Ministry of Health is already planning to make medical examinations mandatory.

Medical examination is so important that it will soon be made mandatory for all Russians

What is the global meaning of medical examination

Health screening is a procedure necessary for every person. Now in Russia the mortality rate is breaking all records. In terms of mortality per year per thousand people, our country is as poor as some southern African countries.

Why is there such a high mortality rate in our country? As a specialist and expert in health psychology, I note that there is a widespread belief among Russians that doctors and officials are responsible for their health, and not themselves. This line of thinking leads to sad consequences. Due to irresponsibility and dislike for one’s own body, obesity has become widespread, and even “younger” by about 20 years.

The health of Russians is undermined by the low quality of life, high prices on medications, difficult working conditions, inability to relax and a vague understanding of the laws by which the human body works.

That is why it is especially important to find time to undergo an examination and obtain reliable information about the state of your health - especially if the state has already provided such an opportunity. How more people will undergo medical examination - especially healthy nation will live in Russia.

However, clinical examination, like any large-scale phenomenon, has both pros and cons. I propose to get acquainted with the advantages and disadvantages of clinical examination and finally decide how much this procedure is necessary for you and your children.

Pros of medical examination:

• Self-care, development of consciousness, understanding of responsibility for health.
• Awareness about current state health.
• Receiving recommendations and consultations to maintain health.
• Early detection of diseases, prevention.
• The opportunity to recover without resorting to operations and expensive treatment.

Disadvantages of medical examination:

• Loss of a working day (until a paid day off is legally established for these purposes).
• You can hear what you don’t want to hear; Not everyone is pleased to hear that, for example, they have developed caries.
• Not all tests can be done within free medical examination( , mammography - not always available).
• We need to come back for test results.
• You may encounter organizational problems: spend more time on examinations, or have to go to diagnostic center as directed by the clinic (for example, for ultrasound or mammography).

How to get a medical examination

In order for as many people as possible to undergo medical examination, the state introduced special conditions for all compulsory medical insurance holders.

Now you can get examined by the most important doctors without grueling waiting in lines. For this purpose, most clinics have departments of medical prevention, which you can contact to undergo medical examination.

If your clinic does not have a medical prevention department, use the help of a therapist. The doctor will give you a “slider” with the numbers of the rooms that you will visit to undergo examinations, obtain notes and signatures from doctors.

What is included in the medical examination

Clinical examination is divided into two stages. Everyone goes through the first stage. The doctor decides who to refer to the second stage based on the results of the first stage.

The first stage of medical examination includes:

• filling out a questionnaire by the patient;
• measurement of height, weight, calculation of body mass index;
• measurement of vascular pressure;
• blood sampling for clinical analysis blood;
• urine collection for general clinical urine analysis;
• blood sampling to determine total cholesterol and blood glucose levels;
• blood sampling for biochemical analysis blood (for patients over 39 years old, frequency - once every 6 years);
• stool sampling for occult blood testing (from 48 to 75 years);
• fluorography;
• mammography for women age 39 and older;
• measurement of intraocular pressure for people aged 39 years and older;
• Ultrasound of organs abdominal cavity and pelvis in patients aged 39 years and older - once every 6 years;
• appointment with a general practitioner.

The second stage of medical examination may include:

• duplex scanning of the brachycephalic arteries (these large vessels are involved in the blood supply to the brain and arms);
• esophagogastroduodenoscopy (examination of the esophagus, stomach and upper duodenum using a special device);
• consultation with a neurologist;
• consultation with a surgeon or urologist: for men aged 42 to 69 years - according to indications; for men, regardless of age - if there is suspicion of cancer prostate gland according to ultrasound results;
• consultation with a surgeon or coloproctologist - if positive analysis stool for occult blood;
• colonoscopy (examination of the inner surface of the colon) or sigmoidoscopy (examination of the mucous membrane of the rectum and sigmoid colon)
• definition lipid spectrum blood - for those whose cholesterol levels are elevated);
• consultation with an obstetrician-gynecologist - for women with identified pathological changes based on the results cytological examination cervical smear and (or) mammography, ultrasound of the uterus and ovaries;
• determination of the concentration of glycated (that is, associated with glucose) hemoglobin in the blood or a glucose tolerance test - if noted increased level glucose;
• consultation with an otorhinolaryngologist is indicated for people aged 75 years and older - if there are medical indications based on the results of a questionnaire or examination by a therapist;
• blood test for the level of prostate-specific antigen - as prescribed by a surgeon or urologist for men with suspected prostate cancer based on the results of a survey, examination, digital examination or ultrasound of the prostate gland;
• consultation with an ophthalmologist - for people aged 39 years and older with high intraocular pressure, and those aged 75 years and older with decreased visual acuity.

Changes to medical examination rules in 2018

From January 1, 2018, a change in cancer screening is “coming” - that is, “checking for cancer.” In the age group from 50 to 75 years, medical examinations will be carried out more often - once every 2 years

In addition, the elderly population age groups will be tested for oncology more often. For diagnosis, they plan to use a new immunochemical method that more effectively detects tumors at an early stage.

The most important thing about medical examination

Please remember that medical examination is an investment in health, which will not allow you to “trigger” the disease and bring yourself to the stage of the disease when money no longer solves anything.

Don't waste time! Sign up for a preventive medical examination, ask questions to specialists through the Medical Note application and stay healthy.

The new bill of the Ministry of Health and Social Development of Russia “On the fundamentals of protecting the health of citizens in the Russian Federation” contains an article about mandatory medical examination population.

Why medical examination is needed, and how it is useful for an ordinary person, says Professor Sergei Boytsov, chief specialist in preventive medicine at the Russian Ministry of Health and Social Development.

What is medical examination?

The official definition of this concept is a set of measures, including a preventive medical examination by doctors of several specialties and the use of the necessary research methods.

When did medical examination appear?

Clinical examination appeared during the USSR due to the principles popular at that time preventive medicine. “Prevention is one of the best qualities medicine of the past,” says Boytsov, “in its updated form it is indispensable even now.”

The task of medical examination was to timely identify socially significant diseases, most often leading to disability and death. These are cardiovascular diseases and cancer.

"IN Soviet time they tried to identify other diseases: ophthalmological, surgical, respiratory diseases, and so on,” says the professor. “Unfortunately, this process is very expensive, labor-intensive, and difficult to organize. Now they are trying to optimize it.”

Back to prevention

Modern medicine around the world operates not only with the concept of “detection of a disease”, but also with such concepts as "risk factor".

“Identify risk factors easier than the symptoms of the disease,” says Boytsov, “both in time and money. Moreover, this more effective: Risk factors can be detected long before the first signs of the disease appear.”

By adjusting a person’s lifestyle so as to get rid of risk factors or reduce their impact, it is possible to postpone the development of the disease for many years or even warn its occurrence.

Who will undergo medical examination?

Clinical examination is carried out in several directions. Here are the main ones:

— Clinical examination of the working population.
— Clinical examination of people working in hazardous conditions or with harmful substances.
— Medical examination of orphans or children in difficult conditions.

However, it is precisely for this group that identifying risk factors and the first signs of socially significant diseases is most important. The group contains quite young people who are still long years good health will be needed.

Since 2011, our country has also carried out medical examinations for adolescents.

“It so happens that with severe symptoms, the patient himself rushes to see a doctor,” says Boytsov, “but people do not pay attention to risk factors and the first manifestations of diseases.”

From what age?

In 2006, an order of the Russian Ministry of Health and Social Development determined the age range in which medical examination should be carried out without fail. This range is from 35 to 55 years.

“The upper limit should be expanded, especially for women,” Boytsov notes. — If men by the age of 55 have already shown symptoms of major diseases, then in women risk factors are only being identified, therefore, diseases can be successfully prevented. With the exception, perhaps, of hypertension, which begins earlier in females.”

What kind of doctors are needed?

Therapist. It determines the risks of cardiovascular diseases based on laboratory research. The therapist analyzes biochemical blood tests that determine glucose and cholesterol levels. These indicators help identify risk factors such as increased blood cholesterol and impaired glucose absorption.

Oncologist. For women over 35 years of age, mammography and examination by a gynecologist are required - studies that can detect the first signs of cervical and breast cancer.

For men, a blood test to determine markers of prostate cancer, and at an older age, an examination by a urologist.

“Despite the fact that some experts consider fluorography not very effective, it should be done at least once every two years,” reminds Boytsov. — Fluorography is needed not only to determine early signs malignant tumors lungs, but also to prevent the development of tuberculosis.”

Why are Health Centers needed?

These institutions are intended for people of all ages, because risk factors various diseases can appear at almost any age.

- I propose to start our conversation, Svetlana Borisovna, by explaining to readers what medical examination is?

This is a set of measures, including a medical examination by doctors of several specialties using the necessary examination methods, subsequent additional examination, determination of health status groups, preventive counseling and, if necessary, therapeutic measures and dynamic monitoring of the health status of identified patients.

Medical examinations are different. Today, for example, we are talking about universal medical examination of the adult population. What are its main differences?

The fundamental differences of general medical examination are that it is differentiated by the age and gender of those examined, a local principle of examination of citizens is introduced, as well as the opportunity to undergo it not only for working people, but also for older people. Medical examination will be carried out using modern equipment that allows identifying diseases at an early stage, as well as the presence of risk factors for their development.

- For what purpose is it carried out?

Clinical examination of the adult population is carried out for the purpose of early detection of chronic non-infectious diseases (conditions), which are the main cause of disability and premature death of a person. We are talking, first of all, about diseases of the circulatory system and, first of all, ischemic disease heart and cerebrovascular diseases; malignant neoplasms; diabetes; chronic diseases lungs.

The fact is that these diseases cause more than 75 percent of all mortality in our country.

In addition, clinical examination is aimed at identifying and correcting the main risk factors for the development of these diseases, which include: increased blood pressure; increased blood cholesterol levels; increased blood glucose levels; smoking tobacco; harmful consumption of alcohol; poor nutrition; low physical activity; overweight or obesity.

An important feature of clinical examination is not only the early detection of chronic non-communicable diseases and risk factors for their development, but also the provision of brief preventive consultation to all citizens with these risk factors, as well as for persons with high and very high total cardiovascular risk individual in-depth and group (patient school) preventive counseling. Such active preventive interventions can quickly and significantly reduce the likelihood of developing dangerous chronic non-infectious diseases in each individual person, and in people already suffering from such diseases, significantly reduce the severity of the disease and the incidence of complications.

- Who is subject to general medical examination?

Every adult citizen (from 21 years of age) has the right to take it once every three years. This year, citizens born in 1912, 1915, 1918, 1921, 1924, 1927, 1930, 1933, 1936, 1939, 1942, 1945, 1948, 1951, 1954, 1957, 1960, 1963, 1 are subject to medical examination 966, 1969, 1972 , 1975, 1978, 1981, 1984, 1987, 1990 and 1993.

For different age categories, as well as for women and men, a specific list of examinations by specialized specialists and diagnostic procedures. All of them will be carried out absolutely free of charge in the clinic at the place of residence, work, or study. Local doctor or local nurse or a receptionist will tell you in detail where, when and how you can undergo medical examination, and agree with the person on the approximate date (period) of undergoing medical examination.

- How does it start?

Medical examination begins with the medical prevention room. There they conduct a questionnaire, anthropometric studies, non-contact eye tonometry from the age of 39, and then the person receives a route sheet and begins to undergo fluorography, mammography, electrocardiography, and so on.

- How is medical examination carried out?

Clinical examination involves two stages. The first stage will involve a general health assessment. A person will be able to undergo testing for cholesterol and blood sugar, electrocardiography, fluorography; for women aged 39 years and older, mammography will be required; for certain age categories - ultrasonography abdominal organs and much more.

The examination of the first stage of medical examination, as a rule, requires two visits. The first visit takes approximately 3 to 6 hours (the scope of the examination varies significantly depending on age). The second visit is usually carried out 1-6 days later (depending on the length of time required to obtain research results) to the local doctor for a final examination and summing up the results of the medical examination.

Those who require a more in-depth examination will be referred to the second stage. It will be carried out to clarify the diagnosis and preventive consultation. Depending on the profile of the identified risks or diseases, the second stage of medical examination may include various studies.

- Where can I get additional medical examination?

Medical examination can be done at the clinic at the place of residence or attachment.

Those interested can contact the prevention office or a local physician.

- How does the additional medical examination end?

The local physician of the polyclinic at the place of residence (attachment), having received the results of the medical examination, informs the patient about the state of his health in general, diagnoses established for the first time, the need for dispensary observation and registration at the dispensary. He also refers for further examination and treatment according to indications, draws up a plan of treatment and rehabilitation measures and explains to the patient the need to follow recommendations aimed at maintaining health.

The results of the medical examination are entered by the general practitioner into a health passport in a form approved by the Ministry of Health of the Russian Federation, which is issued to the citizen.

- If it is easier for people who are on a well-deserved rest to manage their own time, then it is more difficult for those who are working. In this regard, the question is: how can a working person undergo medical examination?
- The legislation determines (Article 24 of the Federal Law of the Russian Federation of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”) that employers are obliged to provide conditions for employees to undergo medical examinations and medical examinations, as well as to freely release employees for their passing.

- In 2013, 15,475 people were examined as part of the medical examination, of which 56.1 percent were men. Pathology was detected in 5,180 cases, including 2,305 people with the disease of cardio-vascular system, 531 – endocrine diseases and 13 had neoplasms. 17 percent of those examined smoke, 15.4 percent eat poorly, and 12 percent are obese.

All patients with identified diseases were registered at the dispensary, and a plan of health measures was drawn up for each patient.

The patient's health groups were distributed as follows. The first group (healthy) – 5864 people (37.9 percent). The second group (citizens with diseases/conditions that do not require additional examination and clinical observation, as well as people with high and very high total cardiovascular risk) – 2927 people (18.9 percent). For such citizens, risk factors are corrected in the medical prevention department or by a local therapist; if necessary, the general practitioner prescribes medication correction. The third group (citizens with diseases requiring medical supervision) – 6,684 people (43.2 percent).

Thus, according to the results of the 2013 clinical examination, about 43 percent of the population should be under the dispensary supervision of local doctors for chronic diseases that pose a threat to life or significantly reduce its quality.

In addition, about 19 percent of our population is at high to very high risk of developing severe cardiovascular complications. This cumulative risk is due to various combinations of factors such as elevated blood pressure, dyslipidemia, tobacco smoking, overweight and obesity, low physical activity, elevated blood glucose levels, and poor nutrition.

- And, perhaps, the last question – is there any special way a person should prepare for medical examination?

To undergo the first stage of medical examination, it is advisable to come to a medical organization (clinic) in the morning, on an empty stomach, before performing any physical activity, including morning physical exercises.

You need to take with you a morning urine sample of 100-150 ml. Before collecting urine, be sure to thoroughly clean the genitals. To collect urine and feces, it is preferable to use industrially produced special containers (small containers) for biosamples, which can be purchased at a pharmacy. To perform a urine test, you need to collect a medium portion of urine (start urinating, and then after 2-3 seconds insert a container for collecting the test). Considering the fact that some foods (beets, carrots) can color urine, they should not be consumed within 24 hours before collecting the material. Also, citizens who take diuretics should, if possible, stop taking them, since these drugs change specific gravity, acidity and amount of urine excreted. A relative limitation is the menstrual period in women. It is advisable that the urine sample be submitted to the laboratory within 1.5 hours after its collection. Transportation of urine should be carried out only at above-zero temperatures, otherwise precipitated salts can be interpreted as a manifestation renal pathology, or completely complicate the research process. In this case, the analysis will have to be repeated.

Persons aged 45 years and older (for stool occult blood testing) must, in order to avoid false positive results, for three days before medical examination, do not eat meat foods, 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 many enzymes such as catalase and peroxidase (cucumbers, horseradish, cauliflower), avoid taking iron supplements medicines, including hematogen, stop taking ascorbic acid, acetylsalicylic acid(aspirin) and other non-steroidal anti-inflammatory drugs (such as voltaren, diclofenac, etc.), stop using any laxatives and enemas.

Avoid excessively diluting the stool sample with water from the toilet bowl. This may cause incorrect results.

You must place a sticker with your last name and initials on the container with urine and feces.

Women need to remember that smears from the cervix are not taken during menstruation or when carrying out any treatment for infectious and inflammatory diseases of the pelvic organs. To reduce the likelihood of getting false results smear analysis, it is necessary to exclude sexual intercourse for two days before medical examination, to cancel any vaginal medications, spermicides, tampons and douching.

Men over the age of 50 should remember that it is better to refrain from undergoing medical examination for 7-10 days after any exposure to prostate gland mechanical in nature (rectal examination, prostate massage, enemas, riding a horse or bicycle, sexual intercourse, treatment rectal suppositories etc.) since they can distort the result of a study of prostate-specific antigen in the blood (tumor marker of prostate cancer).

If a person in the current or previous year passed medical research, he must have with him documents confirming this, which should be shown medical workers before starting medical examination.

The scope of preparation for the second stage of medical examination will be explained by the local doctor.

At the end of our conversation, I want to emphasize that regular medical examination will allow a person to significantly reduce the likelihood of developing the most dangerous diseases, which are the main cause of disability and mortality in our country, or to identify them at an early stage of development, when their treatment is most effective.

I wish everyone health and invite you to a medical examination!