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Medical examination, what tests and examinations are included. How to undergo medical examination for an adult. Day off to visit the clinic

In Russia, an order of the Ministry of Health of the Russian Federation has come into force, according to which people over 40 years of age will be able to undergo a medical examination once a year, while for residents of the country aged 18–39 years, it remains possible to undergo an examination once every 3 years.

Medical examination has become annual for everyone over 40(new order of the Russian Ministry of Health)

In 2019, free medical examination of the adult population under the compulsory medical insurance policy will take place in accordance with Order of the Ministry of Health of the Russian Federation “On approval of the procedure for conducting preventive medical examination and clinical examination of certain groups of the adult population” dated March 13, 2019 N°124n.

To undergo medical examination, the patient must contact the local doctor during his office hours, or in the office. N°215, or to the clinic reception.

  • on weekdays: from 08 00 to 20 00 on weekdays;
  • every third Saturday of the month: from 8 00 to 15 00.

What has changed?

Firstly, since 2019, medical examination and medical examination have been combined. Order N°124n, which comes into force on May 6, 2019, optimizes the regulation of preventive medical measures for the population. It immediately replaces two previously existing orders of the Ministry of Health of the Russian Federation:

  • “On approval of the Procedure for conducting preventive medical examination” dated December 6, 2012 N°1011n;
  • “On approval of the procedure for conducting clinical examination of certain groups of the adult population” dated October 26, 2017 N°869n.

When and by whom are medical examinations and free medical examinations carried out since 2019?

Previously, it was stipulated that a medical examination was carried out once every 2 years, and medical examinations were carried out once every 3 years. The set of analyzes and studies varied (in the year of clinical examination - a larger volume).

Important! According to Order N°124n, free preventive medical examinationor medical examinationcitizens of all ages is annual. Clinical examination is carried out annually for citizens over 40 years of age and once every 3 years for citizens aged 18 to 39 years.

Note! A citizen undergoes a preventive medical examination and medical examination at a medical organization where he receives primary health care. This organization must be licensed to provide all types of medical services included in the medical examination.

What does free medical examination for adults include in 2019?

The medical examination program primarily includes all studies and tests that are included in the annual medical examination.

A preventive medical examination is carried out for the early detection of conditions, diseases and risk factors for their development, non-medical use of narcotic drugs and psychotropic substances, as well as for the purpose of determining health groups and developing recommendations for patients and includes:

  1. Fluorography or x-ray of the lungs (once every 2 years).
  2. Survey (questionnaire).
  3. Calculation based on anthropometry of body mass index (measurement of height, weight, waist circumference).
  4. Blood pressure measurement.
  5. Blood test for total cholesterol.
  6. Blood test for glucose.
  7. Determination of cardiovascular risk (relative - from 18 to 39 years inclusive, absolute - from 40 to 64 years inclusive), risks of chronic diseases.
  8. Measuring intraocular pressure (during the first medical examination, annually from age 40).
  9. ECG (at the first medical examination, annually from age 35).
  10. Examination by a paramedic (midwife) or obstetrician-gynecologist of women aged 18-39 years.

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

Medical examination is a set of measures that includes a preventive medical examination and additional examination methods carried out to assess health status (including determining the health group and the clinical observation group).

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

  • general blood test (hemoglobin, leukocytes, ESR) - from 40 years of age;
  • examination by a paramedic (midwife) or obstetrician-gynecologist of women aged 40 years and older.
  • stool examination for occult blood (from 40 to 64 years inclusive - once every 2 years, from 65 to 75 years inclusive - annually);
  • esophagofibrogastroduodenoscopy - at the age of 45 years;
  • for women: cytological examination of a smear from the cervix (from 18 to 64 years inclusive - once every 3 years),
  • mammography (from 40 to 75 years inclusive - once every 2 years);
  • for men: determination of prostate-specific antigen (PSA) in the blood (at 45, 50, 55, 60, 64 years).
  • examination by a general practitioner based on the results of the first stage.

Additional examination at the second stage of medical examination for adults

At the second stage of medical examination, studies are carried out based on the results of the first stage of medical examination as prescribed by the general practitioner. In this case, the following are assigned:

  • consultations with specialists (neurologist, otorhinolaryngologist, ophthalmologist, surgeon or urologist, surgeon or proctologist, obstetrician-gynecologist, examination by a general practitioner based on the results of the second stage of medical examination);
  • additional studies (radiography of the lungs or computed tomography of the lungs, colonoscopy, esophagofibrogastroduodenoscopy, sigmoidoscopy, spirometry, duplex scanning of the brachiocephalic arteries).

Note! Currently 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-retirees and pensioners. However, the Chairman of the Government of the Russian Federation has given instructions to prepare changes: all working citizens over 40 years old will be provided one day for medical examination every year.

From May 6, the rules for medical examinations for adults have completely changed. The previous order is no longer valid: a new one has been adopted. Now men and women over 40 years of age will be able to get examined for free every year, the program includes oncology diagnostics, and some tests and procedures will be done more often. If you take care of your health and don’t want to overpay, here are the new conditions. Everything is free and voluntary.

How to check your health for free

The rules for medical examination have changed, but it is still free and voluntary. Here is the main thing that all owners of a compulsory medical insurance policy need to know:

  • From the age of 18, you can undergo a preventive examination every year. This is an abbreviated list of examinations, it is free.
  • Medical examinations are now carried out more often: up to 39 years of age - once every three years, from 40 years of age - once a year.
  • Cancer screening was included in the medical examination. They will be carried out even at the age of 18 and even at the first stage - if there are no complaints or testimony.
  • Medical examinations are carried out in clinics, health centers, paramedics and mobile stations. Check with the registration desk and websites for details.
  • Medical examination rooms are open in the evenings and on weekends, so you don’t have to take time off from work.
  • You can take a paid day off during working hours.
  • To register, you only need a passport and insurance policy. The state pays.

What is free medical examination?

Medical examination for adults is free examinations, tests and examinations in the clinic. You can undergo it from the age of 18, even if nothing hurts and there are no complaints at all. The doctor will still see you, look at you, send you for tests and give a referral to specialists. So you can get a free mammogram, colonoscopy, ECG, take a blood test, check your thyroid gland and find out if there are any cancers at an early stage.

If, based on the results of the examinations, it turns out that you are healthy, great. But if suddenly there are signs of a disease that has not yet manifested itself, there is a chance to detect it in time and begin treatment.

You don't need to pay for anything. But examinations and tests are prescribed not at the request of the patient, but only those that are in the rules of medical examination. They are approved by the Ministry of Health. There are lists for each age and indication.

For now, the websites of clinics and even health departments have old rules and orders. Almost everywhere the wrong age and the wrong lists of examinations are indicated. Focus on the new lists - they are already in force.

Who can get a free medical examination?

Examinations and examinations at the expense of the budget are required for all adults over 18 years of age. This does not depend on having a job, position, gender, status or political views. The main thing is to have a compulsory medical insurance policy and be assigned to a clinic. It can be changed once a year if desired.

Medical examination can be carried out every three years. After 40 years - every year

Now you can undergo free medical examination from the age of 18. But not every year, but once every three years at a certain age: 18, 21, 24, 27, 30, 33, 36, 39 years. Previously, it was possible only from 21 years of age.

From May 6, men and women who are already 40 years old can undergo such examinations annually: at 41, 42, 43 years old, and so on. This is a new condition; previously the interval for everyone was three years, but now the older you are, the more often you can be examined at the expense of the state. If you were examined at 39 years old, you can go to the clinic again at 40. You won’t have to wait for 42 years like before.

Age is determined not by date of birth, but by year. In the year you turn 30, 33 or 40 years old, you can already go for free examinations, even if your birthday is still three months away.

There are also surveys that have their own frequency. For example, an ECG is done every year, but only from the age of 35, feces are checked for occult blood from 39 to 64 years old, every two years, a PSA test as part of the first stage of medical examination for men from the age of 45 is taken every five years, and mammography for women from the age of 39 done every two years. Doctors monitor this - they have tables and instructions on who is entitled to what.

Everyone goes through the first stage of medical examination

Clinical examination is carried out in two stages. In general, nothing has changed here, but a new list of examinations has been approved.

First you need to see a therapist. He will ask questions about health, habits and lifestyle, and give directions for tests. The list of examinations depends on age.

General examinations during medical examination and medical examination

From 18 to 39 years old From 40 to 64 years old From 65 years old
Questionnaire, questions on lifestyle and risks 1 time per year 1 time per year 1 time per year
Measuring height, weight, waist circumference, blood pressure 1 time per year 1 time per year 1 time per year
Cardiovascular risk according to a special scale 1 time per year 1 time per year
Fluorography 1 time every 2 years 1 time every 2 years 1 time every 2 years
ECG during the first medical examination, then from the age of 35 once a year 1 time per year 1 time per year
Intraocular pressure at the first medical examination 1 time per year 1 time per year
Gynecologist 1 time per year 1 time per year 1 time per year
Therapist Once every 3 years 1 time per year 1 time per year
General blood analysis 1 time per year 1 time per year
Blood test for sugar and cholesterol 1 time per year 1 time per year 1 time per year

You can undergo a preventive examination without medical examination - from the age of 18 at least every year. This is a separate type of health check, it exists on its own. There are fewer examinations, there is no second stage and no cancer screening, but it will still help you monitor your health.

The second stage is prescribed only when indicated

If risks are detected at the first stage, the doctor will issue referrals for in-depth examinations. This is necessary to clarify the diagnosis.

At the second stage, you can undergo the following examinations as prescribed by your doctor:

  • Consultation with a neurologist.
  • Scanning of the brachiocephalic arteries in men from 45 to 72 years and women from 54 to 72 years.
  • Consultation with a surgeon or urologist for men 45, 50, 55, 60 and 64 years old.
  • Consultation with a coloproctologist from 40 to 75 years.
  • Colonoscopy.
  • Gastroscopy.
  • X-ray or computed tomography of the lungs.
  • Spirometry.
  • ENT consultation from 65 years old.
  • Consultation with an ophthalmologist from the age of 40.

Each examination is recommended only for specific indications. They are listed in paragraph 18 of the order of the Ministry of Health. You can ensure that when examining elderly relatives, the doctor prescribes everything that is required. If the grandmother suspects a lung tumor, a CT scan should be done, and if the grandfather has an elevated PSA, he should be sent to a urologist. If colon cancer is suspected, a colonoscopy is performed. If a person smokes, spirometry may be prescribed. Such research is very expensive and sometimes it is too late.

After all the examinations, the doctor will determine your health group. If serious illnesses are discovered, the patient will be registered and monitored under another order - with treatment and rehabilitation.

Cancer screenings will be carried out as part of the medical examination.

Now, even at the first stage of clinical examination, screening will be carried out in order to detect oncology in time. For each age there is a separate list of examinations. There are examinations even for 18 years old.

What examinations will be prescribed to detect cancer at the first stage?

What they check At what age What examination
Cervical cancer from 18 years old once a year examination by a gynecologist
from 18 to 64 years old once every 3 years smear for cytology
Breast cancer from 40 to 75 years old once every 2 years mammography
Prostate cancer at 45, 50, 55, 60, 64 years old PSA blood test
Bowel cancer from 40 to 64 years old once every 2 years, from 65 to 75 years old once a year feces for occult blood
Cancer of the skin, lips, mucous membranes, thyroid gland and lymph nodes at any age at every examination visual inspection and palpation
Esophageal carcinoma at 45 years old gastroscopy

At the second stage, in-depth examinations for oncology will be carried out. All this is free.

costs of cancer screening for women in a paid clinic

Where do medical examinations take place?

Medical examination must be carried out at your clinic or paramedic station. In theory, there are mobile mobile teams. If medical examination is required due to age, they are waiting for you at the clinic right now.

When can I get tested?

According to the usual schedule. Examinations are carried out as usual at the clinic. But sometimes separate days, doctors and offices are allocated for this. Usually the information is available on websites, or you can check with the reception desk when it’s more convenient to come and get tested right away.

In the evening and on Saturday. Recently, amendments have been made regarding medical examinations on weekends and in the evenings. The law was passed so that more people could be examined without taking time off from work. Doctors will be paid additionally for this, but the exact time must be clarified at the clinic: not everyone has yet been able to adapt to these changes. But many have been seeing patients in the evenings and on Saturdays for a long time.

During business hours. By law, you can take a paid day off from work for medical examination. True, for now, for people over 40 years old and before retirement age, the condition remains that this day off is given once every three years, although they can undergo medical examinations annually. But this will be fixed soon. In 2019, everyone can definitely take a day off like this.

By registration via the Internet. To register for examinations, you must register electronically. You can already make an appointment with a doctor on the government services portal and clinic websites. But it’s better to clarify how this works in your clinic. It may be easier to come without an appointment on Saturday before lunch and they will be waiting for you there specifically for a medical examination.

Is it possible to check your health if nothing hurts?

Yes, this is the essence of medical examination. Analyzes, examinations and examinations are carried out without complaints, simply because you came specifically for a medical examination and all this is included in it according to the terms of the program. Even if at 30 years old nothing hurts at all, the clinic will still conduct cancer screening based on age, do fluorography and check the blood for sugar and cholesterol.

If there are complaints, then regardless of the medical examination, the doctor will prescribe the necessary examinations. For example, if you complain about a lump in the breast, they will do a mammogram, even if this examination is not yet included in the medical examination due to age. If something hurts or bothers you, don't wait forty years or until two years have passed since your last check: go to the doctor as usual. Clinical examination does not replace treatment in clinics and hospitals - it is also free. And if you pay yourself, you can get a deduction and get some of the money back.

Is it possible to undergo medical examination if you do not work officially and do not pay fees?

Yes, even those who do not work or work without a work book and do not contribute anything to the budget can undergo medical examination. The budget pays premiums for such people, but they are still insured. If you have a policy, you also have the right to free medical examination. No one will check how many fees you have paid and what your income is. The clinic will receive the money after it records that this person has been examined.

Tens of billions are allocated from the budget for health checks. If you don’t master them through free examinations, they will still go somewhere.

Medical examination in 2019 - what is included in it and how to go about it?

From January 1, 2019, it will be easier for Russian employees to undergo medical examination. To do this, you do not have to ask your employer for time off. The right to a legal and paid day off once every 3 years (in accordance with the medical examination schedule) is now granted to all employees, and pre-retirement workers are even “gifted” with 2 days off every year. The corresponding law on medical examination of the population in 2019 was adopted at the end of 2018.

We will tell you in more detail how the medical examination will take place in 2019 - which years of birth are included in the examination, how it will be carried out and what it will include.

Why is medical examination needed?

In the Russian Federation, a program of free, voluntary medical examination has been operating for more than five years. This measure is essentially a routine examination of the population, carried out for the purpose of prevention, detection of chronic diseases in the early stages, increasing the general medical literacy of the population, and developing healthcare. Citizens of the entire country can participate in medical examinations; this is not a privilege for residents of Moscow or St. Petersburg. Russians throughout the country, from the Moscow region and Tatarstan to Krasnoyarsk, can count on an equal amount of analysis of their own health.

Important! Statistics show that citizens tend to treat their own health with surprising indifference. Thus, in Kurgan, the obstacle to medical examination was precisely the indifference of the population and the management of enterprises and organizations (which was successfully overcome thanks to the work of the health authorities and in 2016 the plan for medical examination was fulfilled in the city by 92%). Medical examination is a very useful event; the process of completing it will take some time, but the end justifies the means. In Voronezh, doctors determined that every second person examined has risk factors for diseases. Read what is included in the medical examination in 2019 and how to complete it.

Legislative regulation and definition of the term

The first order for medical examination of the adult population was adopted back in 2012, in 2015 it was canceled, and serious changes were made to the procedure for undergoing medical examinations, which were approved by Order 869n. This normative act, in turn, is based on Art. 46 Federal Law-323 dated November 21, 2011 “On the basics of protecting the health of citizens in the Russian Federation.” This law contains general standards for the organization of healthcare in our country. Every year a new procedure for completing the procedure is approved.

Taking into account all of the above and the provisions of paragraph 2 of Order 869n, we can give a definition of medical examination. This is a set of preventive and research medical measures (this includes a survey, examinations by specialists in various fields, tests, etc.), carried out in order to determine the state and health group of a particular person, as well as improve the general level of health of the population.

Mandatory medical examination. Review of Order of the Ministry of Health and Social Development 302n dated 04/12/11

Basic principles

Principles of medical examination established by current legislation:

  • universality (every citizen of the Russian Federation who has reached the age of 21 and has a compulsory medical insurance policy can take part). Medical examination of children is not provided for by the above order, since according to the order of the Ministry of Health of the Russian Federation No. 1346n of 2012. The health examination of minors begins from the moment of their birth and is carried out annually. Since the condition of the little one requires more careful monitoring of him, in the period up to one year the examination is carried out monthly, from one to two years - 3 times, from two years to three years - 2 times;
  • planned nature (conducted annually and every year citizens of a certain year of birth are examined, the next examination can be done after 3 years);
  • accessibility for all segments of the population, medical examination is completely free;
  • voluntariness, a citizen has the right at each stage to refuse both the entire complex of medical measures and their specific part.

Review of the list of vital and important drugs (VED) for 2018

Citizens of what year of birth are being examined this year?

Medical examination of the adult population in 2019 is carried out for those born in certain years.

Citizens of what year of birth will undergo medical examination in 2019 can be determined by yourself. To do this, it is necessary to determine whether the patient’s age in the current year is divisible by 3 without a remainder. If yes, then he has the right to a free preventive examination.

A table indicating specific years can be found on the official websites of the Ministry of Health of the Russian Federation or the Ministries of Health of the regions. Here you can also track current regulatory changes; the official website of the Ministry of Health of St. Petersburg, for example, regularly publishes articles and news on clinical examination.

New sample compulsory medical insurance policy: pros and cons of a plastic card

How to get a medical examination?

In 2019, all medical organizations that are required to provide free services to the population are participating in the program. You can undergo an examination at the clinic if you have a compulsory medical insurance policy and present a passport, and it does not matter whether the citizen is studying, working or is unemployed. In order to receive free time in the organization to complete all stages of the examination, it is necessary to notify the employer about the examination in writing.

From January 1, 2019, in accordance with Federal Law No. 353-FZ dated October 3, 2018, employees can receive exemption from work for 1 day every three years to undergo medical examination, and workers of pre-retirement age - for 2 working days every year (Article 185.1 of the Labor Code RF).

What to do if you missed your year? You can apply for a preventive examination, which is carried out every two years. The list of analyzes will be half as long, but they can identify critical problems.

What is the medical examination procedure?

The general program includes two stages: based on the results of the first, screening, the health group is determined (from 1 to 3, depending on the identification of risk factors for the acquisition and presence of chronic diseases at the current moment); if necessary, the patient is sent based on the results of the first for a more in-depth examination of his health status, which represents the second stage.

Briefly about the main thing: answers to popular questions

Dmitry from St. Petersburg asks: “I’m interested in the medical examination for 2019, which years are included in St. Petersburg and how to calculate it?”

To do this, it is necessary to divide the age that will be reached in the current year by 3. If there is no remainder, the citizen has the right to undergo a free examination.

Alexandra from Perm asks: “I’m interested in what has changed in the medical examination procedure in 2019, what is included in it today?”

The list of tests is updated every year; special attention is now paid to the prevention and detection of cancer. At the same time, abdominal ultrasound, general and biochemical blood tests, and urine tests were excluded from the program as ineffective.

Ekaterina from Chelyabinsk asks: “How is the medical examination carried out, what doctors and examination tests are provided for by the program?”

The list of examinations for age groups is different. A complete list of all tests and examinations for various categories of citizens can be found on the official websites. The doctor must conduct a general examination, interview, and measure the patient’s data.

In 2019, the following procedures are still required:

  • fluorography of the chest organs;
  • electrocardiography is prescribed for men over 36 years of age, women are prescribed upon reaching 45 years of age;
  • analysis for the level of total cholesterol and glucose in the blood.

There are also current changes, mammography is now carried out for women aged 39 to 49 years, men from 45 to 51 undergo a PSA test, and men of this age undergo intraocular pressure measurement. Consultation with an ophthalmologist, neurologist, surgeon, and spirometry are prescribed for elderly people.

Daria from Yekaterinburg asks: “I wonder if there are differences depending on the region of residence. For example, how is medical examination carried out in 2019, what years of birth fall in Yekaterinburg? How does it work in practice, if they refuse free tests, what should you do?”

The rules for conducting the examination are uniform for the entire country; there are no differences by region; for absolutely everyone, all tests and procedures included in the first and second stages are free. Additional measures are carried out only with the consent of the patient in accordance with the general procedure. Those undergoing medical examination cannot be included in the general queue; refusal to carry out any procedures is also unlawful. If the procedure is violated, you can appeal the actions of doctors to the administration, local health department, or court. You can also contact the prosecutor's office, insurance company, or health care committee.

Kirill from Moscow asks: “How to get a medical examination at the clinic at your place of residence?”

You must go to the clinic at your place of residence with your passport, compulsory medical insurance policy and patient card. First, you will be referred to a therapist, then for the necessary examinations. If any tests have already been taken shortly before the medical examination, you must take their results with you.

What you need to know before undergoing medical examination

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

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

Clinical examination involves examination by medical specialists and a number of tests and examinations. It is carried out at the place of your attachment. Working citizens are issued a certificate of inspection on the same day. 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. Medical examinations can also be taken in the evenings and on Saturdays.

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.

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

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

To undergo medical examination, you must:

3. Appropriate by age. Medical examination is carried out once every 3 years, and you can undergo it during the year in which you turned or will turn: 18, 21, 24, 27, 30, 33, 36, 39 years old. If you are 40 years or older, you can undergo medical examination annually.

Some The following undergo annual medical examination:

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

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

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

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

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

">preferential categories of citizens undergo medical examinations annually, regardless of age.

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

3. How will the medical examination take place?

Step 1. Fill out the required documents.

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

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

Step 2. Prepare for examinations.

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

">40 years or older, you will need to have a stool test for occult blood, so check with the clinic in advance if If immunochemical, no dietary restrictions are required. If by another method - within 3 days before the examination, refuse foods high in iron (meat, apples, white beans), laxatives and enemas, iron supplements, aspirin and ascorbic acid.">what method this analysis is being done.

Step 3. Complete the first stage of medical examination.

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

Step 4. Come to see a general practitioner.

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

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

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

Step 6 Consult your doctor.

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

If there are diseases, the necessary treatment is prescribed, including specialized and high-tech medical care, as well as sanatorium-resort treatment.

If you smoke, are overweight, obese, or have other risk factors, you may be referred to a preventative care unit or office where they can provide help to correct your risk factors.

4. Which doctors should I see if I am between 18 and 39 years old?

The first stage of clinical examination:

1. Preventive medical examination:

  • survey (questioning)
  • determination of the level of total cholesterol in the blood;
  • determination of blood glucose levels;
  • determination of relative cardiovascular risk (for patients aged 18-39 years);
  • fluorography (once every 2 years);
  • appointment (examination) based on the results of a preventive medical examination, including an examination to identify visual and other localizations of oncological diseases, including examination of the skin, mucous lips and oral cavity, palpation of the thyroid gland, lymph nodes, by a paramedic at a medical center or a medical and obstetric station, a general practitioner or a medical prevention doctor at a medical prevention department (office) or a health center.

2. Screening for early detection of cancer:

For women:

  • examination by a paramedic (midwife) (18 and older);
  • 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;

3. Brief preventive consultation;

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

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

5. Which doctors should I see if I am between 40 and 45 years old?

The first stage of clinical examination:

  • measurement of height, body weight, waist circumference, determination of body mass index;
  • blood pressure measurement;
  • determination of absolute cardiovascular risk (for patients from 40 to 64 years old);
  • electrocardiography at rest (performed during the first preventive medical examination, then at the age of 35 years and older once a year);
  • for women over 40 years old - mammography;
  • for men aged 45 years: determination of prostate-specific antigen (PSA) in the blood;
  • for patients 45 years of age of both sexes - esophagogastroduodenoscopy;
  • If you are between 40 and 64 years old, the test must be taken once every two years, if you are between 65 and 75 years old - annually.">40 years and older
  • measurement of intraocular pressure (performed during the first preventive examination, then at the age of 40 years and older once a year).
  • examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary);
  • examination (consultation) by a surgeon or urologist (for men aged 45 years with an increase in the level of prostate-specific antigen in the blood more than 1 g/ml);
  • colonoscopy - in case of suspected colon cancer, as prescribed by a surgeon or coloproctologist;
  • esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
  • X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
  • examination (consultation) by an ophthalmologist (for patients over 40 years of age with increased intraocular pressure);
  • individual in-depth preventive counseling or group preventive counseling (patient school).

6. Which doctors should I see if I am between 46 and 50 years old?

The first stage of clinical examination:

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

If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.

Second stage of clinical examination (if necessary):

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

7. Which doctors should I see if I am between 51 and 74 years old?

The first stage of clinical examination:

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

If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.

Second stage of clinical examination (if necessary):

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

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

The first stage of clinical examination:

  • measurement of height, body weight, waist circumference, determination of body mass index;
  • blood pressure measurement;
  • conducting a general blood test (hemoglobin, leukocytes, ESR);
  • determination of the level of total cholesterol in the blood using an express method;
  • determination of fasting blood glucose levels (using the express method is allowed);
  • fluorography of the lungs (not performed if fluorography, radiography (fluoroscopy) or computed tomography of the chest organs was performed in the previous calendar year or in the year of medical examination);
  • electrocardiography at rest;
  • measurement of intraocular pressure (performed once a year);
  • for women aged 75 years: mammography;
  • for patients of both sexes aged 75 years: stool test for occult blood.

If you have taken any of the tests listed or had any of the examinations listed in the past 12 months, their results may be included in the medical examination.

Second stage of clinical examination (if necessary):

  • examination (consultation) by a neurologist - if there is a suspicion of a previous acute cerebrovascular accident, depression in patients over 65 years of age, with motor dysfunction, etc.
  • duplex scanning of brachycephalic arteries - for patients aged 75-90 years, referred by a neurologist;
  • examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (if necessary) - for patients under the age of 87 years;
  • spirometry - if a chronic bronchopulmonary disease is suspected based on the results of a questionnaire, for smokers - in the direction of a therapist;
  • esophagogastroduodenoscopy - if there is a suspicion of malignant neoplasms of the esophagus, stomach and duodenum - as prescribed by the therapist;
  • X-ray of the lungs, computed tomography of the lungs - if malignant neoplasms of the lung are suspected - as prescribed by the therapist;
  • examination (consultation) by an otolaryngologist (if necessary);
  • examination (consultation) by an ophthalmologist - for patients with increased intraocular pressure, and for patients aged 75 years and older who have a decrease in visual acuity that is not amenable to glasses correction, identified by the results of a questionnaire;
  • individual in-depth preventive counseling or group preventive counseling (patient school).

9. My age is not on the list for medical examination. What examination can I undergo?

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

The advantage of a preventive medical examination is that it can be performed at any age at the request of the patient. The medical examination is carried out free of charge, annually. Preventive medical examination studies are included in stage 1 of medical examination.

  • measurement of height, body weight, waist circumference, determination of body mass index;
  • blood pressure measurement;
  • determination of the level of total cholesterol in the blood using an express method;
  • determination of blood glucose levels using the express method;
  • determination of relative cardiovascular risk in citizens aged 18 to 39 years;
  • determination of absolute cardiovascular risk in citizens aged 40 to 64 years;
  • fluorography of the lungs once every 2 years;
  • electrocardiography at rest (performed during the first preventive medical examination, then at the age of 35 years and older once a year);
  • measurement of intraocular pressure (performed during the first preventive examination, then at the age of 40 years and older once a year);
  • for women under the age of 39 - examination by a paramedic (midwife) or an obstetrician-gynecologist.

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

    ">examination to identify possible cancer diseases, with recommendations.

    If you are diagnosed with signs or a high risk of disease, your general practitioner will refer you for additional examination.

    Recently in Russia, those over 21 years of age can take advantage of the medical examination program. In 2019, a new stage will start, designed for the participation of the mass of citizens of the Russian Federation.

    The main goal is to determine what is happening with health, as well as to identify chronic diseases at an early stage. Such control reduces various types of risks and helps reduce the mortality rate, especially among young people. In addition, monitoring makes it possible to detect illnesses in representatives of different ages and generate up-to-date statistics.

    For each age group there is a list of the most likely diseases identified by doctors. Based on this list, a list of general and narrow specialists is being prepared, who must comprehensively examine each person subject to medical examination.

    The diagnostic system allows us to identify most pathologies that can be successfully treated in the early stages, which often allows patients to prevent serious conditions, including disability or death.

    Particular attention is paid to deviations from the norm in the functioning of the cardiovascular and bronchopulmonary systems, to any tumors and formations, disruptions of the endocrine system, which in 20% of cases cause premature death of a person.

    Not all Russian citizens are covered by the program, but only those born in certain years from 1920 to 1998. The “step” at the age of the subjects is 3 years.

    According to this table, the years covered by medical examination in 2019 are: 1920, 1923, 1926, 1929, 1932, 1935, 1938, 1941, 1944, 1947, 1950, 1953, 1956, 1959, 1962, 1965, 1971, 1974 , 1977, 1980, 1983, 1986, 1989, 1992, 1995, 1998.

    There are no restrictions for people over 100 years old. They can undergo dispensary screening according to general rules.

    The planned medical examination in 2019 is carried out everywhere - in all regions of Russia.

    Preventive examination has the following goals:

    • Diagnosis in the early stages of dangerous diseases that lead to disability or premature death.
    • Preventing the transition of the disease from acute to chronic.
    • Control over the epidemiological situation in a country or a particular region.
    • Obtaining statistical data on the prevalence of dangerous diseases in different regions of the country and drawing up a plan to combat them.
    • Identification of factors and primary causes of the development of certain ailments.
    • Consulting citizens on the need for timely diagnosis and prevention of various diseases.
    • diabetes;
    • cardiovascular failure;
    • cerebrovascular accident;
    • diseases of the digestive tract.

    Those people whose age is divisible by three can undergo medical examination in 2019. The program covers citizens of the following year of birth:

    • 1920;
    • 1923;
    • 1926;
    • 1929;
    • 1932;
    • 1935;
    • 1938;
    • 1941;
    • 1944;
    • 1947;
    • 1950;
    • 1953;
    • 1956;
    • 1959;
    • 1962;
    • 1965;
    • 1968;
    • 1971;
    • 1974;
    • 1977;
    • 1980;
    • 1983;
    • 1986;
    • 1989;
    • 1992;
    • 1995;
    • 1998.

    Preferential categories of the population can undergo free medical examination, regardless of age. These include:

    • disabled people of the Great Patriotic War and combatants who received serious injuries;
    • people awarded the distinction “Resident of besieged Leningrad”;
    • persons who are recognized as disabled due to a general illness or work injury;
    • prisoners of concentration camps or other places of forced detention created by the Nazis during the Second World War.

    Medical examination of children takes place somewhat differently. Pediatricians from district clinics monitor newborns and babies from one year old. The schedule for periodic examination of the reception corresponds to the characteristics of child development. The age of children for an extended comprehensive examination should correspond to 1, 3, 6, 7, 10, 14-17 years.

    Screening carried out regarding the health of children has its own characteristics. Every child, starting from the age of 1 year, has the right to medical examination, which is carried out in Russia annually.

    The age of children who can undergo an extended examination of this type is: 1, 3, 6, 7, 10, 14, 15, 16, 17 years. This is due to the peak occurrence of age-related diseases during these periods.

    This event is carried out within the framework of a children's clinic, where the child is served by a local therapist. All actions take place in accordance with the order of the Ministry of Health of the Russian Federation No. 134 of 2012, which prescribes the rules and requirements for medical screenings.

    In 2019, children born in the following years should be invited to clinics for primary medical examination: 2018, 2017, 2016, 2013, 2012, 2009, 2004, 2003,2002.

    Medical examination is provided both for working citizens who undergo periodic medical examinations, and for people who do not have a permanent or official job.

    Any person going for an examination has the right to undergo it free of charge, as determined by the Federal Law on the Fundamentals of Protecting the Health of Citizens in the Russian Federation. For this reason, all tests and other examinations within the program are paid for from the state treasury.

    A full examination is the right of every person. You can get information about the time of its implementation, as well as the schedule, if you contact the reception desk, the therapist working at the site, or the nurse. In a situation where the employer has an agreement with a medical institution, the employee examination schedule will be provided to management. Almost all clinics invite people for medical examinations by telephone or using other options.

    A person may refuse medical examination or not undergo examination by a specific specialist. But the refusal should be formalized by filling out a form drawn up according to the approved form with the signature of the person who refuses the proposed medical examination. This form is provided at the clinic.

    Surveys show that people are often deprived of the opportunity to undergo medical examination due to lack of time. In a number of regions, employers last year offered those for whom medical examination is not obligatory to take a day off “at their own expense” or use time off to conduct a survey.

    But a bill came into force obliging employers to give employees a day off for medical examinations.

    The bill was presented by Valery Ryazinsky together with United Russia deputies. This happened back in 2016, but the document was sent for revision. Trade unions approved the initiative, but employers reacted with restraint, since another day off and the prospect of workers being diagnosed with occupational diseases does not bode well for them. But in 2018, the law was adopted with some changes and additions.

    Among the nuances, the following should be highlighted:

    • any employee who is not of retirement age can take a day every three years to undergo a medical examination;
    • workers approaching retirement age can count on two days each year to get tested;
    • a day given for medical examination is paid as usual;
    • the date of medical examination is set by the medical institution according to the existing schedule;
    • the schedule of medical examinations must be provided to the employer, who will notify subordinates about the medical examination.

    In this case, the employer has the right to demand from the employee confirmation that he has undergone medical examination (a certificate with marks from specialists).

    Clinical examination 2019 and all its stages remain unchanged - they are standard. To pass, you need to present a passport, SNILS, and a health insurance policy.

    The initial stage is a primary examination, including:

    • a visit to a therapist, who fills out a so-called “risk questionnaire”, where physical parameters (for example, weight), as well as bad habits and dietary features are noted;
    • visit to specialists;
    • necessary tests;
    • some studies (fluorography, ultrasound).
    • examination by a gynecologist and smear (women);
    • ECG (people born in 1983 and older);
    • intraocular pressure (born in 1977 and older);
    • examination by a neurologist (born 1968 or older).

    If certain abnormalities are identified during the examination, the patient is referred for additional examination.

    Each institution draws up its own schedule, which indicates the days of examinations. 3 days are allotted for tests and consultations.

    Depending on the number of specialists, as well as the prescribed studies, 7 hours should be enough for the main examination.

    If the patient has the results of fluorography done less than a year ago, you need to take them with you and show them to the therapist - then you can do without this procedure.

    Each of those who underwent medical examination in 2019 should be assigned to one of three groups:

    • Group I. People without detected pathologies, as well as signs of their occurrence;
    • Group II. Persons who have no ailments but are at risk of developing them;
    • III group. People with detected pathological processes (tumors, hypertension, etc.).

    The doctor will talk with representatives of the first two, talking about their health status, and, if necessary, providing nutritional recommendations. Based on the results of the medical examination, each participant will receive a Health Passport, which contains diagnoses and recommendations.

    To undergo a medical examination, it is enough to have:

    1. passport;
    2. medical insurance policy;
    3. SNILS.

    As a result of a detailed study of the body, each citizen receives a Health Passport. It lists diseases, if any, as well as recommendations for maintaining health.

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