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Mandatory medical examination per year. How to undergo medical examination for an adult

Features of the first stage

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

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

Regardless of your health...

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

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

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

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

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

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

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

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

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

Men can't get away either

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

AND NOW - ATTENTION!

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

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

Where to contact?

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

What documents are needed?

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

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

Changes to the Labor Code and other innovations

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

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

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

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

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

How to get a medical examination

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

or see a therapist

or see a general practitioner.

You need to take with you to your appointment:

insurance policy;

patient's medical record (if it was kept by the patient).

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

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

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

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

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

to the administration of the medical institution;

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

to the regional health department;

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

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

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

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

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

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

Clinical examination 2018: which years of birth are included	Clinical examination 2019: what years of birthfall

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

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

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

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

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

disabled people of WWII and combat,

former child prisoners of concentration camps with disabilities

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

Clinical examination is a free medical service for citizens aged 18 years and older, with the aim of identifying diseases in the early stages or risk factors that are the main causes of disability and premature mortality in the Russian population.

Clinical examination has been introduced in Russia since 2013 as part of the compulsory health insurance program.

Medical examination, which is carried out every three years, can be done at the district clinic at the place of registration upon presentation of a passport and compulsory health insurance policy.

In 2018, Russian citizens born in the following years will be able to undergo medical examination: 1928, 1931, 1934, 1937, 1940, 1943, 1946, 1949, 1952, 1955, 1958, 1961, 1964, 1967, 1970, 1973, 976, 1979, 1982, 1985, 1988, 1991, 1997.

Medical examination does not apply to persons included in special categories that are subject to medical supervision annually - children, disabled people of the Great Patriotic War, military personnel and others.

How to get

To undergo a medical examination, you must contact the registry office of the district clinic for information. They will tell you where, when and how you can get tested and agree on an approximate date with you.

Clinical examination is carried out in two stages. The first stage includes two visits to the clinic: the first - an examination, the scope of which depends on age, and the second - to the local doctor within a week for a final examination and summing up the results of the first stage of medical examination.

If the results of the first stage reveal at least a suspicion of the presence of a chronic non-infectious disease or a high cardiovascular risk, the local doctor refers the person undergoing the examination to the second stage of medical examination.

In particular, the patient is prescribed an additional examination - depending on age and gender, a list of specialists, laboratory and diagnostic procedures is determined.

Before starting medical examination, your local doctor needs to show the results of a medical examination if you underwent them in the current or last year.

Who can pass

Clinical examination is universal and does not depend on whether a person works or not, or studies in an educational institution.

Medical examination is a voluntary event, which is formalized in accordance with the regulations of the Ministry of Health of the Russian Federation.

A citizen has the right to refuse medical examination either entirely or from certain stages of medical examinations; you just need to remember that medical examination allows you to identify diseases that are asymptomatic in the first stages and begin treatment on time.

Employed persons can visit a medical facility during working hours; the employer cannot prevent them from doing this, nor can their absence from the workplace be regarded as a violation of labor discipline. A similar rule applies to full-time students.

Surveys

The range of activities carried out within the program differs depending on gender and age. Any patient who applies for a free medical examination in 2018 will be able to undergo an examination and receive advice from several specialists: a gynecologist, urologist, cardiologist, ophthalmologist, endocrinologist and dentist.

All age groups donate blood for sugar and cholesterol, a general urine test and an electrocardiogram.

Clinical examination, in addition to a set of studies common to all age groups of patients, also includes in-depth studies designed for early detection of the most likely chronic non-infectious diseases for a given age and gender.

Thus, starting from the age of 39, citizens undergo ultrasound examination (US) of the abdominal cavity and pelvis once every six years, and women undergo mammography once every three years.

Also, after 39 years, intraocular pressure is checked to exclude glaucoma, and after 48 years, a stool test is performed for occult blood of the gastrointestinal tract, which helps to identify early cases of oncology. In addition, each patient fills out a special questionnaire to identify hereditary diseases and risk factors for the development of chronic non-communicable diseases. More detailed information can be found.

Based on the results of the research, the citizen is assigned a health group. After this, people who need to undergo further examination are sent to the second stage, which includes laboratory and instrumental examinations, consultations with specialists.

Doctors believe that the medical examination program in terms of instrumental and laboratory examinations is much broader and allows us to identify not only diseases in the early stages, but also risk factors for their development.

The material was prepared based on open sources

Clinical examination is a set of medical diagnostic measures for the population of the Russian Federation, which is designed to assess the level and state of health of the citizens being examined for preventive purposes. In other words:

timely monitor the dynamics of psychological and physiological state;
inform citizens about their risk factors for chronic non-communicable diseases;
identify newly emerging health problems in a timely manner in order to effectively treat them in the early stages of their occurrence, preserving the person’s health as much as possible and even saving his life;
More regularly, people (“chronicles”) receive medical recommendations on the treatment of their existing chronic non-infectious diseases.

Medical examination can be defined as a preventive medical examination. In the Russian Federation, people are required to undergo this All-Russian Preventive Medical Examination certain categories of citizens from the general population. Therefore, in medical literature and in advertisements you can hear such wording as “ Clinical examination of certain groups of the adult population" (DOGVN) or " Medical examination of the adult population"(DVN), in the first and second we are talking about the same thing. Something is not clear? Now you will understand!

The above formulations indicate that the age of citizens subject to this comprehensive medical examination in the current year should be equal to (or turn this year): 21 years old, 24, 27 years old, 30, 33 years old, 36 years old, 39, 42 years old, 45 years old, 48, 51 years old, 54, 57 years old, 60, 63 years old, 66 years old, 69, 72 years old, 75 years old, 78, 81 years old, 84, 87 years old, 90, 93 years old, 96 years old, 99 years old.

That is, DOGVN (DVN) is carried out to all citizens, starting from the age of 21, and so on, at intervals every 3 years, throughout their lives (as long as this federal program exists). Until reaching the 99-year mark. It is clear that after 3 years, those who were 18 years old then (in 2016) will be included here, and the former 21-year-olds (2016) will reach the age of 24 (2019) and beyond.

When did it start

Since 2013, a federal program for general medical examination of the population of the Russian Federation began to operate. Then the procedure for medical examination of Russians was outlined in detail in the order of the Ministry of Health of Russia dated December 3, 2013 No. 1006n. Every year, new updated orders of the Ministry of Health of the Russian Federation are issued with clarifications, changes and additions.

For example, the latest:

Order of the Ministry of Health of the Russian Federation No. 869n dated October 26, 2017 “On approval of the procedure for medical examination of certain groups of the adult population”
Methodological recommendations “Organization of medical examination of certain groups of the adult population”

Main goal, idea and principle

The main goal of this program: to examine all Russian citizens over the course of three years, starting from the age of twenty-one, the result of which is expected to prevent premature mortality through timely diagnosis and identification of risks in the early stages of severe chronic diseases.

The idea of all-Russian medical examination of the adult population as a system for monitoring the health status of citizens dates back to the times of the Soviet Union. When developing the system, the Ministry of Health set a goal to carry out constant medical monitoring of the health of Russian citizens, starting from the day of their birth and continuing at all ages.

The federal program of universal medical examination takes into account the most critical peaks of morbidity at each age. On their basis, a differentiated list of specialists who need to be visited has been approved for all age groups of adults and children.

A whole range of diagnostic measures is designed to detect non-infectious pathologies that are causes of premature mortality and disability. Here they highlight:

disorders of the circulatory system,
diseases of the lungs and respiratory tract,
malignant neoplasms,
benign tumors,

If not detected in a timely manner, these diseases lead to premature death in 4 out of 5 cases.

What is it for?

Despite the fact that medical examination is a voluntary event (and if so, it can also be said to be optional), health workers still recommend regular examinations. Because a preventive examination, carried out in a complex, makes it possible to obtain a complete picture of a citizen’s health, determine future predisposition to diseases, and make a forecast for the development of pathologies.

As usual, we go to a clinic or emergency room in emergency cases, but identifying diseases in the early stages makes it possible to make our treatment simpler, more timely and less expensive. Preventive medical intervention is the key to health and active longevity.

What does it include

Clinical examination includes a number of sequential activities (brief overview):

A medical examination by a local general practitioner with the preparation of a questionnaire to identify risk factors (for example: overweight, eating disorders, smoking tobacco, taking alcohol and psychoactive substances, low physical activity, the presence of cancer and diabetes in relatives).
Women are referred to a gynecologist.
Examination by narrow specialists (at the second stage of DVN).
Laboratory diagnostics (for example: urine tests, blood tests, smears from the cervical canal, feces for occult blood using immunochromatography, blood for sugar and cholesterol).
Instrumental diagnostics (for example: undergoing fluorographic examination of the chest organs, ultrasound examination of the abdominal organs, pelvis (ultrasound examination has been abolished since 2017)).

In addition to this, people:

over 36 years of age, electrocardiography is performed (for men);
over 40 years of age, intraocular pressure is measured (currently at 60 years of age and older);
over 50 years of age are referred for consultation to a neurologist (only at the 2nd stage).

Currently, the list of studies has undergone some changes. But let’s look at the full list of examinations at the first and second stages of medical examination in the second part of the publication.

Health groups

When risk factors are identified, the patient is recommended for additional testing, which is called second stage medical examination. But even after the first stage of its completion, citizens are assigned health categories. The children's medical examination is structured similarly.

The first health group is people without the need for constant monitoring in a medical institution.
The second group includes individuals with a high predisposition to cardiovascular and other diseases.
The third group are people who need constant supervision from specialists.

Currently, health group 3 is divided into 3a and 3b.

Medical examinations can last up to three days.

Age of patients: what years undergo clinical examination in 2019, 2020 and 2021

A medical examination is a labor-intensive and expensive procedure for the country’s budget, so it is not carried out annually among citizens in a continuous manner, but begins at the age of 18 and is repeated once every three years. This streamlines the examination of citizens and makes it possible to check the health status of each of them every three years.

Look, I made tables of ages suitable for DVN three years in advance.

Medical examinations in 2019, as well as in 2020 and 2021, are offered to those Russians whose dates of birth and age correspond to:

What age citizens have already undergone medical examination in 2019: table

Year of birth	Age	Year of birth	Age
2001	18	1959	60
1998	21	1956	63
1995	24	1953	66
1992	27	1950	69
1989	30	1947	72
1986	33	1944	75
1983	36	1941	78
1980	39	1938	81
1977	42	1935	84
1974	45	1932	87
1971	48	1929	90
1968	51	1926	93
1965	54	1923	96
1962	57	1920	99

In 2020: table

Year of birth	Age	Year of birth	Age
2002	18	1960	60
1999	21	1957	63
1996	24	1954	66
1993	27	1951	69
1990	30	1948	72
1987	33	1945	75
1984	36	1942	78
1981	39	1939	81
1978	42	1936	84
1975	45	1933	87
1972	48	1930	90
1969	51	1927	93
1966	54	1924	96
1963	57	1921	99

In 2021: table

Year of birth	Age	Year of birth	Age
2003	18	1961	60
2000	21	1958	63
1997	24	1955	66
1994	27	1952	69
1991	30	1949	72
1988	33	1946	75
1985	36	1943	78
1982	39	1940	81
1979	42	1937	84
1976	45	1934	87
1973	48	1931	90
1970	51	1928	93
1967	54	1925	96
1964	57	1922	99

As you have already noticed, citizens who underwent medical examination of the adult population in 2018 will undergo it again in 2021, and, of course, young people born in 2003 will be added to them!

Where can you get a medical examination in 2019?

It can be taken at clinics at the place of your permanent or temporary registration. You need to take with you:

passport,
SNILS
and medical insurance policy.

Comprehensive diagnostics are carried out free of charge if you have a compulsory health insurance policy!

Based on the results of a visit to a medical institution, a citizen receives detailed information about his condition and individual recommendations for maintaining health and preventing the onset or progression of the disease.

And although the federal program has been implemented for the sixth year in a row, not all Russian citizens know about it. There are many people who are indifferent to their state of health.

Who can I get information about a medical examination from?

You can get detailed information from your local doctor, local nurse, or at the reception desk about which medical institution and when the medical examination will take place in 2019.

It should be noted that this event is held throughout Russia in all cities:

Moscow,
Ekaterinburg,
Krasnoyarsk,
Chelyabinsk,
Kirov,
Mound,
Tula,
Kazan,
Magnitogorsk,
Cherepovets,
Vladivostok,
Novosibirsk,
Krasnodar,
Volgograd,
Tolyatti,
Samara,
Orenburg,
Kursk,
Vologda and all the others.

Read related publications related to this section:

What does a complete list of studies of the first and second stages of medical examination include?

The new Order of the Ministry of Health of the Russian Federation No. 869n dated October 26, 2017 “On approval of the procedure for carrying out clinical examination of certain groups of the adult population,” which guides health care institutions when conducting this general preventive examination, includes two stages of conducting DVN, the second is carried out as needed (availability of indications).

First stage of DOGVN

Stage 1 includes:

survey (survey) once every 3 years, in order to identify complaints characteristic of non-communicable diseases, personal history, smoking, alcohol consumption, the risk of consuming narcotic drugs and psychotropic substances, nutritional patterns, physical activity, as well as for the purpose of identifying citizens aged 75 years and older risk of falls, complaints characteristic of osteoporosis, depression, heart failure, uncorrected hearing and vision impairment;
anthropometry (measurement of height, standing, body weight, waist circumference), body mass index calculation 1 time every 3 years;
measurement blood pressure 1 time every 3 years;
determination of the level of general blood cholesterol(use of the express method is allowed) for citizens under the age of 85 once every 3 years;
definition blood glucose levels on an empty stomach (using the express method is allowed) once every 3 years;
definition relative cardiovascular risk for citizens aged 21 to 39 years inclusive, and absolute cardiovascular risk for citizens aged 42 to 63 years inclusive, who do not have diseases associated with atherosclerosis, type 2 diabetes mellitus and chronic kidney disease, once every 3 years;
carrying out individual preventive counseling in the department (office) of medical prevention (health center, paramedic health center or paramedic-obstetric station) for citizens under the age of 72 with high relative and high and very high absolute cardiovascular risk, and (or) obesity, and (or) hypercholesterolemia with a total cholesterol level of 8 mmol/l or more, and (or) smoking more than 20 cigarettes per day; referral of these citizens to in-depth (individual or group) preventive counseling outside the framework of medical examination;
resting electrocardiography(for men aged 36 years and older, for women aged 45 years and older once every 3 years);
inspection paramedic (midwife), taking using a cytological brush cervical smear (scraping) from the surface of the cervix(external uterine pharynx) and cervical canal for cytological examination (hereinafter referred to as cervical smear), cytological examination of cervical smear (for women aged 30 to 60 years, once every 3 years);
fluorography of the lungs 1 time every 3 years;
mammography both mammary glands in two projections (for women aged 39-48 years, once every 3 years and for women aged 50-70 years, once every 2 years);
study stool for occult blood immunochemical method (for citizens aged 49 to 73 years, once every 2 years);
definition prostate-specific antigen(PSA) in the blood (for men aged 45 years and 51 years);
measurement intraocular pressure 1 time every 3 years (for citizens aged 60 years and older);
reception (examination) general practitioner upon completion of studies of the first stage of clinical examination, carried out at intervals of 1 time every 3 years, including establishing a diagnosis, determining a health group, a clinical observation group, conducting a brief preventive consultation, including recommendations on a healthy diet, level of physical activity, cessation of tobacco smoking and harmful consumption alcohol, determination of medical indications for examinations and consultations as part of the second stage of medical examination;
appointment (examination) with a general practitioner upon completion of studies of the first stage of medical examination, carried out periodically 1 time every 2 years in the presence of identified pathological changes, including the determination, in accordance with the identified changes, of medical indications for examinations and consultations as part of the second stage of medical examination.

Second stage of DVN

The second stage of medical examination is carried out for the purpose of additional examination and clarification of the diagnosis of the disease (condition) and includes:

examination (consultation) neurologist(in the presence of newly identified indications or suspicions of a previously suffered acute cerebrovascular accident for citizens who are not under dispensary observation for this reason, as well as in cases of detection of motor function disorders, cognitive impairments and suspicions of depression based on the results of a questionnaire in citizens aged 75 years and older, who are not under dispensary observation for this reason);
duplex scanning of brachycephalic arteries(for men aged 45 to 72 years and women aged 54 to 72 years with a combination of three risk factors for the development of chronic non-communicable diseases: high blood pressure, hypercholesterolemia, overweight or obesity, and also upon referral by a neurologist for the first time identified indication or suspicion of a previously suffered acute cerebrovascular accident for citizens aged 75-90 years who are not under dispensary observation for this reason);
examination (consultation) surgeon or urologist(for men aged 45 years and 51 years with an increase in the level of prostate-specific antigen in the blood more than 1 ng/ml);
examination (consultation) surgeon or coloproctologist, including sigmoidoscopy (with a positive stool test for occult blood, for citizens aged 49 years and older with a family history of adenomatosis, colorectal cancer, when other medical indications are identified based on the results of a questionnaire, as well as as prescribed by a general practitioner , urologist, obstetrician-gynecologist in cases of identifying symptoms of colorectal cancer);
colonoscopy(for citizens in case of suspected colon cancer as prescribed by a surgeon or coloproctologist);
spirometry(for citizens with suspected chronic bronchopulmonary disease based on the results of a survey, who smoke on the direction of a general practitioner);
examination (consultation) obstetrician-gynecologist(for women aged 30 to 69 years inclusive with identified pathological changes based on the results of a cytological examination of a cervical smear and (or) mammography);
examination (consultation) otolaryngologist(for citizens aged 75 years and older if there are medical indications based on the results of a questionnaire or examination by a general practitioner);
examination (consultation) ophthalmologist(for citizens aged 60 years and older who have increased intraocular pressure, and for citizens aged 75 years and older who have decreased visual acuity that cannot be corrected with glasses, identified by the results of a questionnaire);
carrying out individual or group(schools for patients) in-depth preventive counseling in the department (office) of medical prevention (health center, paramedic health center or paramedic-obstetric station) for citizens;
reception (examination) general practitioner, upon completion of studies of the second stage of clinical examination, including establishing (clarifying) the diagnosis, determining (clarifying) the health group, determining the group for clinical observation (taking into account the opinions of medical specialists), as well as referring citizens, if there are medical indications, to an additional examination not included in the scope of medical examination to receive specialized, including high-tech, medical care, for sanatorium and resort treatment.

Content

People who consider themselves healthy are not always so. Diseases that can be dealt with at an early stage are identified in an advanced form; curing them is difficult and sometimes impossible. Clinical examination - a preventive medical examination of the population - helps in the timely diagnosis of serious pathologies. What features does this service have in 2019, what does it include? To maintain health, it is useful to know the types of examinations, tests, and procedure.

What is medical examination

The Ministry of Health of the Russian Federation, having studied the morbidity statistics in the country, in 2013 decided on a routine medical examination of the entire population. Medical examination is a free service provided by clinics, an easy way to find out the state of your health. Medical checkup:

is carried out voluntarily;
covers all groups of adults, starting from the age of 21, children from birth;
carried out at the place of registration;
requires the presentation of a compulsory medical insurance policy and a passport.

To undergo a medical examination in 2018 at the clinic, you need to find out which year of birth patients should take part in it. There is a special schedule for routine inspections. For each age group it is specified which procedures are included in the examination. The task of a dispensary medical examination for adults is the timely identification of diseases in patients that affect mortality and the initiation of their treatment. These include:

diseases of the heart, blood vessels, lungs;
oncological pathologies;
chronic non-infectious diseases;
diseases of the endocrine system;
diabetes.

No less important in 2018 is a medical examination of the child, which is carried out according to its own schedule, starting with those born in 2001. A list of specialists who need to be visited has been agreed upon. Children undergo a medical examination in a clinic or kindergarten:

up to a year– monthly;
from 1 to 2 years– quarterly;
from two to three- semiannually;
6-7, 10, 14-15, 16-17 years- annually.

Timetable by year of birth

Free medical examination of the population helps the patient save significant amounts on medical research. The state allocates huge funds so that Russian citizens can undergo early diagnosis of dangerous diseases. To ensure an even load on medical institutions, a special schedule for medical examinations has been proposed. To determine the date of your visit to the clinic, you can:

check the schedule on the website of any medical institution providing such a service;
divide your age by 3, if the result is without a remainder, you should do an examination.

In 2018, adult patients and children born during the period, including start and end dates, must undergo a clinical examination:

	Period, years	Year of birth
Adults	from 1919 to 1937	1922, 1925, 1928, 1931,1934
	from 1940 to 1958	1943, 1946, 1949, 1952, 1955
	from 1961 to 1979	1964, 1967, 1970, 1973, 1976
	from 1982 to 2000	1985, 1988, 1994, 1997
	from 2001 to 2017	from 2001 to 2004, inclusive

Objectives

Timely diagnosis helps facilitate the treatment process and prolong the patient’s life. The task of conducting a dispensary medical examination 2018 throughout the country is to identify the health status of the population. As a result of the surveys, the healthcare system:

has information about the spread of diseases;
identifies risk factors leading to chronic pathologies;
carries out adjustments to methods that are included in plans for regular population surveys.

The goals of conducting dispensary medical examinations in adults:

early diagnosis of chronic diseases - causes of life threatening, disability, premature death;
in-depth examination by specialists of a narrow profile;
definition of preventive measures;
prescription of treatment, rehabilitation procedures;
consultation of patients at risk;
registration at the dispensary;
increasing life expectancy and improving its quality.

Medical examination focuses on diseases that often lead to serious consequences. Regular examinations help preserve and maintain the health of the country's citizens. The list of pathologies that are studied during a medical examination includes:

diseases of the nervous and cardiovascular systems;
diabetes;
glaucoma;
pulmonary failure;
malignant neoplasms;
chronic diseases of non-infectious etiology;
diseases of the endocrine system.

The objectives of the 2018 dispensary medical examination for children are different. The objectives of the event include:

strengthening and maintaining health;
improvement of mental and physical development;
organization of social adaptation;
ensuring hormonal development;
detection of pathologies at an early stage;
timely treatment;
preventive measures to exclude complications, progression of the disease, and the onset of disability.

Changes in the general medical examination program in 2018

The Ministry of Health of the Russian Federation, based on statistical data, regularly adjusts the activities included in the list of necessary examinations during preventive dispensary medical examinations. Due to the lack of required equipment in medical institutions and low information content, the following were excluded in 2018:

general blood analysis;
ultrasonography;
Analysis of urine.

As a result of the high mortality rate from cardiovascular pathologies and cancer, during the 2018 clinical examination the range of examinations was expanded, which included the following at a frequency of once every two years:

Stages of implementation

A preventive medical examination begins with a visit to a general practitioner, who collects anamnesis and conducts a survey of the patient. The person receives a route sheet, where all the examinations that need to be completed are noted. The patient is given a health passport form, which is filled out by specialists. The list of doctors who need to be visited, taking into account the patient’s age and health status, includes:

endocrinologist;
cardiologist;
dentist;
ophthalmologist;
gynecologist;
mammologist;
urologist;
neurologist.

The general practitioner receives conclusions from specialists, results of tests and examinations. Based on the results of the first stage of preventive medical examination:

assesses the patient's condition;
gives preventive recommendations;
establishes a health group;
makes suggestions for treatment;
issues a passport when examinations are successfully completed.

Preventive medical examination moves to the second stage if the patient is diagnosed with:

increased intraocular pressure;
deviations in blood counts;
ECG changes;
pathologies of the nervous system;
the likelihood of developing neoplasms;
deviations in the functions of the genitourinary system of men and women;
risk of developing a heart attack, vascular pathologies.

Additional clinical examination includes an in-depth examination of patients by specialized specialists using special hardware techniques and laboratory tests. At the second stage, consultations with doctors are prescribed:

oncologist;
proctologist;
surgeon;
coloproctologist;
otorhinolaryngologist;
ophthalmologist;
neurologist;
gynecologist;
urologist;
mammologist.

What examinations are included in the medical examination 2018

A medical examination begins with a visit to a therapist, who fills out a questionnaire together with the patient. He determines which doctors undergo medical examination in accordance with age, makes notes on the route map about the necessary examinations. The doctor, through a survey, identifies risk factors for the development of chronic diseases:

the presence of a hereditary predisposition;
physical activity;
diet;
consumption of alcohol, drugs;
smoking;
the presence of symptoms of pathologies.

The 2018 dispensary medical examination includes mandatory examinations and procedures for all, taking into account the patient’s age:

blood test for sugar and cholesterol levels;
electrocardiogram;
fluorographic examination of the lungs;
cervical smear for women;
mammography of the mammary glands;
stool occult blood test;
examination by a gynecologist;
appointment with a neurologist;
determination of intraocular pressure.

Visit to a therapist and general tests

To undergo medical examination in a clinic, the patient first goes to a general practitioner. The therapist invites him to fill out a special questionnaire, which records the factors that provoke the development of chronic ailments and predisposition to them. At the initial examination:

blood pressure is measured;
body weight and height are determined;
Referrals are given for mandatory tests and examinations.

Based on the results of the first stage of clinical examination, the therapist:

summarizes the results of the medical examination;
establishes the patient’s health group;
gives recommendations on preventive measures;
if necessary, sends for an in-depth examination by specialized specialists - oncologist, urologist, surgeon;
prescribes therapeutic measures;
fills out the statistical form and the patient’s health passport.

Referral to a neurologist

A visit to this specialist during medical examination is necessary after 51 years of age. The therapist may send the patient for examination by a neurologist if indicated. Mandatory consultation includes checking:

memory, thinking by solving problems, memorizing pictures;
spatial sensations - performing actions with eyes closed;
sensitivity by tingling method;
facial expressions;
eye movements;
turning the head;
coordination of movements with closed and open eyes.

To clarify the diagnosis, the neurologist may prescribe additional hardware and laboratory tests:

encephalography– determination of brain activity;
electroneuromyography– study of peripheral nerves;
x-ray– examination of the skull and brain;
computed tomography– detailed examination of minor defects;
dopplerography– determination of blood flow speed in cerebral vessels;
magnetic resonance imaging– study of the functioning of the cerebral cortex;
blood test for proteins, hormones– detection of infectious lesions of the nervous system.

Gynecologist and mammologist for women

Reproductive health issues are a priority, so women should visit a gynecologist annually. During clinical examination, patients are interviewed and examined, a smear is taken, and the mammary glands are palpated to identify pathologies. To detect diseases of the female genital organs, the doctor finds out:

the beginning of the menstrual cycle;
its duration, the nature of its course;
beginning of sexual activity;
use of oral contraceptives;
regularity of sexual intercourse;
presence of pregnancies, childbirth, abortions.

Breast cancer is widespread among women, but with early diagnosis it can be successfully treated, so clinical examination includes a mammological examination - an X-ray of the mammary glands. If changes are detected, the woman is sent for a consultation to a mammologist, who diagnoses diseases of the mammary glands and refers them for treatment or surgery. The doctor reveals:

benign, malignant neoplasms;
hereditary pathologies;
hormonal imbalances that provoke illnesses;
inflammatory processes in the breast - mastitis.

ECG for men over 36 years old

The rhythms of modern life, constant stress, poor environment and bad habits have led to an increase in the number of young men with problems with the functioning of the heart and blood vessels. The Ministry of Health of the Russian Federation decided to conduct an ECG as part of the medical examination in 2018. The examination results are deciphered by the doctor. The test includes determination in men after 36 years of age:

rhythm regularity;
heart size;
blood supply;
heart rate;
the presence and nature of the teeth, their polarity, size, height.

Carrying out an ECG during medical examination helps to assess the state of the cardiovascular system and make a decision on an in-depth examination and treatment. The technique helps to identify in young men:

myocardial infarction;
coronary heart disease;
tachycardia;
bradycardia;
cardiac aneurysm;
ventricular hypertrophy;
extrasystole;
myocarditis;
pericarditis;
myocardial dystrophy;
pulmonary embolism.

Features of complex diagnostics depending on age

In addition to mandatory studies, during the 2018 medical examination, special measures are prescribed that are necessary for patients at risk. The information was collected on the basis of statistical reports on the health status of the country's population. Taking into account age, additionally included in the medical examination of an adult:

When undergoing medical examination, doctors prescribe additional diagnostic procedures taking into account the patient’s age:

Type of study	Detection of the disease	Age, years
Feces for occult blood	Colon cancer
Abdominal ultrasound	Gastritis, stones, neoplasms
Determination of prostate-specific antigen levels	Prostate cancer
Visit to a neurologist	Brain lesions
Examination by a mammologist	Neoplasms in the mammary gland
	Heart pathologies	men over 36 women – from 45

What tests are taken during medical examination in 2018?

To identify diseases during a dispensary medical examination, mandatory laboratory tests are carried out. The list includes a blood test that helps identify the development of inflammatory processes and chronic diseases. With its help, the content is determined:

total cholesterol;
glucose;
alanine aminotransaminases;
creatinine level;
total bilirubin;
aspartate aminotransaminases.

Conducting laboratory tests helps to accurately identify dangerous diseases at the onset of development and take measures to restore the patient’s health. During medical examination 2018, the list of mandatory tests includes:

feces for occult blood - excludes the appearance of malignant neoplasms of the rectum;
cytological examination of a cervical smear in all women under 70 years of age is an early diagnosis of cancer.

How is the health group determined based on screening results?

After conducting examinations during clinical examination 2018, doctors assign patients. This is a symbol necessary for subsequent analysis of a person’s condition and the appointment of therapeutic and preventive procedures. In adults, three groups are distinguished. The first is characterized by:

absence of chronic diseases;
maintaining a healthy lifestyle;
rare ailments, colds;
slight deviations in blood pressure readings.

The second health group, as a rule, includes middle-aged patients and retirees, who are characterized by:

chronic diseases without complications;
bad habits – smoking, drinking alcohol;
improperly organized nutrition;
limited physical activity;
tendency to develop diabetes mellitus, pathologies of the heart and blood vessels.

According to the results of medical examination 2018, the third health group includes patients:

requiring constant supervision by specialists;
having pathologies that worsen the quality of life;
those suffering from serious illnesses;
those with a disability group with partial or complete incapacity for work;
facing regular exacerbation of chronic diseases.

During the medical examination of children in 2018, 5 health groups are distinguished, depending on the general condition of the patient and the presence of chronic ailments:

first– no problems with physical or mental health, normal functioning of all organs;
second– there are no chronic diseases, there is a decrease in immunity, functional impairment, excess weight, developmental delay, weight loss, weakened vision.

The following health groups include children with more serious problems:

third– chronic pathologies in remission, growth retardation, body weight deviations, delayed psychological development;
fourth– exacerbation of chronic illnesses, consequences of trauma operations, presence of limitations in studies;
fifth– serious illnesses with frequent attacks, complications, physical developmental defects, organ dysfunction, disability.

Health passport with examination results

When a patient undergoes medical examination in 2018, in addition to the outpatient card and route sheet, he has one more document in his hands. Health passport - the conclusion of all specialists on the results of examinations. It, along with the medical record, is filled out by each doctor with whom the patient was examined. The document includes:

personal data;
compulsory medical insurance policy number;
membership in a health group;
recommendations of narrow specialists.

After passing the medical examination, the health passport is given to the patient until the next medical examination. The therapist enters into the document: