Methodical recommendations for clinical examination of the year. Clinical examination of the adult population. Ministry of Health of the Russian Federation

Information on the conduct of preventive medical examination and clinical examination of the adult population.

From May 2019 entered into force new order conducting a preventive medical examination and medical examination of the adult population, approved by order of the Ministry of Health of the Russian Federation dated March 13, 2019 No. 124n "On approval of the procedure for conducting preventive medical examination and medical examination of certain groups of the adult population" (hereinafter - the Order).

In accordance with the Order, the population aged 18-99 years is subject to an annual preventive examination / clinical examination.

IMPORTANT! The clinical examination is considered incomplete if the activities included in the oncological screening have not been taken.

Preventive medical examination -it is a complex of medical examinations carried out in order to early (timely) detection of conditions, diseases and risk factors for their development, as well as in order to identify health groups and develop recommendations for patients.

According to the new procedure, a preventive medical examination is carried out annually as an independent event, within the framework of medical examination, as well as within the framework of dispensary observation and includes:

• questioning of citizens aged 18 and over;
• calculation based on anthropometry (measurement of height, body weight, waist circumference) of body mass index, for citizens aged 18 years and older;
• measurement of blood pressure in peripheral arteries for citizens aged 18 years and older;
• a study of the level of total cholesterol in blood for citizens aged 18 years and older;
• fasting blood glucose determination for citizens aged 18 and over;
• determination of the relative cardiovascular risk in citizens aged 18 to 39 years inclusive;
• determination of the absolute cardiovascular risk in citizens aged 40 to 64, inclusive;
• fluorography of the lungs or radiography of the lungs for citizens aged 18 years and older, once every 2 years;
• resting electrocardiography during the first preventive medical examination, then at the age of 35 and older;
• measurement of intraocular pressure during the first prophylactic medical examination, then at the age of 40 and older;
• examination by a paramedic (midwife) or obstetrician-gynecologist of women aged 18 to 39 years;

Clinical examination -a set of measures, including a preventive medical examination and additional methods of examinations conducted in order to assess the state of health (including the definition of a health group and a dispensary observation group).

Clinical examination of the adult population is carried out annually at the age of 40 and older, once every three years at the age of 18 to 39 years inclusive, as well as in relation to certain categories of citizens.

Clinical examination is carried out in two stages.

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

The first stage of clinical examination includes:

1.Preventive medical examination:

• survey (questionnaire)
• measurement of height, body weight, waist circumference, calculation of body mass index;
• blood pressure measurement;
• study of the level of total cholesterol in the blood;
• determination of blood glucose levels;
• determination of the risk of cardiovascular diseases (from 18 to 64 years old);
• fluorography (once every 2 years);
• resting electrocardiography (at the first examination, then at the age of 35 and older);
• measurement of intraocular pressure (at the first examination, then from 40 years);
• reception (examination) based on the results of a preventive medical examination, including examination for the detection of visual and other localizations of oncological diseases, including examination of the skin, mucous membranes of the lips and oral cavity, palpation of the thyroid gland, lymph nodes, a paramedic of a paramedic health center or a paramedic obstetric center, a general practitioner or medical prevention doctor of a department (office) of medical prevention or a health center.

2. Screening for early detection of oncological diseases:

• Fecal occult blood test (once every 2 years at the age of 40 to 64 years, once a year at the age of 65 to 75 years;
• Esophagogastroduodenoscopy at 45 years old;

For women:

• Examination by a paramedic (midwife) (from 18 to 39 years old);
• Taking a smear from the cervix, cytological examination of a smear from the cervix 1 time in 3 years at the age from 18 to 64 years;
• Mammography (once every 2 years from the age of 40 to 75)

For men:

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

3. Brief preventive counseling;

4. General blood test (from 40 years of age and older);

Second phase 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;
• duplex scanning of brachycephalic arteries (for men aged 45 to 72 years inclusive and women aged 54 to 72 years);
• examination (consultation) by a surgeon or urologist (for men aged 45, 50, 55, 60 and 64 with an increase in the level of prostate-specific antigen in the blood of more than 4 ng / ml);
• examination (consultation) by a surgeon or coloproctologist, including sigmoidoscopy (for citizens aged 40 to 75, inclusive);
• colonoscopy (for citizens in case of suspicion of malignant neoplasms of the large intestine, as prescribed by a surgeon or coloproctologist);
• esophagogastroduodenoscopy (for citizens in case of suspicion of malignant neoplasms of the esophagus, stomach and duodenum as prescribed by a therapist);
• x-ray of the lungs, computed tomography of the lungs (for citizens in case of suspicion of malignant neoplasms of the lung, as prescribed by a therapist);
• spirometry;
• examination (consultation) by an otorhinolaryngologist (for citizens aged 65 and over);
• examination (consultation) by an obstetrician-gynecologist (for women aged 18 years and older with identified pathological changes;
• examination (consultation) by an ophthalmologist (for citizens aged 40 and over);
• conducting individual or group (school for patients) in-depth preventive counseling in the department (office) of medical prevention (health center) for citizens aged 65 and over;

When carrying out a preventive medical examination and medical examination, the results of previously conducted (no later than one year) medical examinations, medical examination, confirmed by the medical documents of a citizen, can be taken into account.

Preventive medical examination or clinical examination is carried out free of charge with a passport and compulsory medical insurance policy in the clinic at the place of attachment, in the department or in the office of medical prevention without an appointment. A necessary precondition for a preventive medical examination and clinical examination is the giving of informed voluntary consent of the citizen.

In 2019, a preventive medical examination can be carried out by citizens aged 19, 20, 22, 23, 25, 26, 28, 29, 31, 32, 34, 35, 37 and 38 years old, medical examination - at the age of 18, 21, 24, 27, 30, 33, 36, 39, 40 and older - annually.

IMPORTANT! The clinical examination is considered incomplete if the activities included in the oncological screening have not been taken.

MINISTRY OF HEALTH OF THE RUSSIAN FEDERATION

ORDER
dated February 3, 2015 N 36an

ON THE APPROVAL OF THE ORDER OF DISPENSERIZATION OF CERTAIN GROUPS OF THE ADULT POPULATION

(as amended by the Order of the Ministry of Health of the Russian Federation of 09.12.2016 N 946n)

2. To declare invalid the order of the Ministry of Health of the Russian Federation of December 3, 2012 N 1006n "On approval of the procedure for conducting clinical examination of certain groups of the adult population" (registered with the Ministry of Justice of the Russian Federation on April 1, 2013, registration N 27930).

Acting Minister
D.V. KOSTENNIKOV

1. This Procedure regulates issues related to medical examination of the following groups of the adult population (aged 18 years and older) in medical organizations:

1) working citizens;

2) non-working citizens;

3) students in educational institutions full-time.

This Procedure does not apply in cases where legislative and other regulatory legal acts of the Russian Federation establish a different procedure for conducting clinical examination of certain categories of citizens.

2. Clinical examination is a set of measures, including a preventive medical examination and additional methods of examinations carried out in order to assess the state of health (including determining the health group and the dispensary observation group) and carried out in relation to certain groups of the population in accordance with the legislation of the Russian Federation. (as amended by the Order of the Ministry of Health of the Russian Federation of 09.12.2016 N 946n)

3. Clinical examination of the adult population is carried out through an in-depth examination of the state of health of citizens in order to:

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

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

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

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

4. Clinical examination is carried out 1 time in 3 years in the age periods provided for by Appendix No. 1 to this Procedure<1>, with the exception of:

1) invalids of the Great Patriotic War and invalids of military operations, as well as 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>;

2) persons awarded the sign "Inhabitant of the besieged Leningrad" and recognized as disabled due to a general illness, work injury and other reasons (except for persons whose disability occurred as a result of their illegal actions)<3>;

3) former juvenile prisoners of concentration camps, ghettos, and other places of detention created by the Nazis and their allies during the Second World War, recognized as disabled due to general illness, work injury and other reasons (with the exception of persons whose disability occurred as a result of their illegal actions)<4>.

<1> The year of the medical examination is the calendar year in which the citizen reaches the appropriate age.

The categories of citizens specified in subparagraphs 1 - 3 of this paragraph undergo medical examination annually, regardless of age.

5. The list of examinations (consultations) by specialist doctors (feldsher or midwife), research and other medical activities carried out as part of the clinical examination, depending on the age and gender of the citizen (the volume of medical examination), is determined in accordance with Appendix No. 1 to this Procedure.

Clinical examination of citizens specified in subparagraphs 1 - 3 of paragraph 4 of this Procedure is carried out in an amount corresponding to the volume of medical examination provided for in Appendix No. 1 to this Procedure for citizens of the closest age category, with the exception of studies that have medical contraindications for annual<1>.

<1> Fluorography of the lungs and mammography are performed once every 2 years, a smear (scraping) from the surface of the cervix (external uterine pharynx) and the cervical canal for cytological examination is carried out once every 3 years.

6. Clinical examination of the adult population is carried out by medical organizations (other organizations carrying out medical activities) (hereinafter referred to as a medical organization), regardless of the organizational and legal form, participating in the implementation of the program of state guarantees of free provision to citizens medical care and the territorial program of state guarantees for the provision of free medical care to citizens in terms of the provision of primary health care, with a license to carry out medical activity, providing work (services) for "preventive medical examinations", "therapy", "obstetrics and gynecology"<1> or "obstetrics and gynecology (excluding assisted reproductive technologies)", "obstetrics" or "general medicine", "ophthalmology", "neurology", "surgery", "radiology", "clinical laboratory diagnostics" or "laboratory diagnostics" , "functional diagnostics", "ultrasound diagnostics", "endoscopy".

<1> For licenses to carry out medical activities issued before the entry into force of the Decree of the Government of the Russian Federation of April 16, 2012 N 291 "On licensing medical activities (with the exception of the specified activities carried out by medical organizations and other organizations that are part of the private health care system in the territory innovation center Skolkovo) "(Collected Legislation of the Russian Federation, 2012, N 17, Art. 1965; N 37, Art. 5002; 2013, N z, Art. 207; N 16, Art. 1970).

If the medical organization carrying out prophylactic medical examination does not have a license to carry out medical activities for certain types of work (services) necessary for carrying out medical examination in full, the medical organization concludes an agreement with another medical organization that has a license for the required types of work (services), on the involvement of the relevant medical personnel in the medical examination.

7. A citizen is undergoing medical examination in a medical organization in which he receives primary health care.

8. Clinical examination is carried out in the presence of informed voluntary consent of a citizen or his legal representative (in relation to a person recognized as established by law legally incapacitated, if such a person, due to his condition, is not able to consent to medical intervention), given in compliance with the requirements established by Article 20 Federal law dated November 21, 2011 N 323-FZ "On the basics of health protection of citizens in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2013, N 48, Art. 6165).

A citizen has the right to refuse to conduct clinical examination in general or from certain types of medical interventions included in the volume of medical examination.

9. The head of the medical organization and medical workers of the department (office) of medical prevention (including that which is part of the health center) are responsible for organizing and conducting medical examination of the population undergoing medical care in a medical organization.

A general practitioner (a local general practitioner, a general practitioner of a workshop medical department, a general practitioner (family doctor)) (hereinafter referred to as a general practitioner) is responsible for organizing and conducting medical examination of the therapeutic population, including a workshop, of a site general practice (family doctor)), served territory (hereinafter referred to as the site).

A paramedic of a paramedic health center or a paramedic-obstetric station is responsible for conducting a clinical examination of the population of a paramedic section in the event that he is assigned certain functions of an attending physician to directly provide medical assistance to a patient during the period of observation and treatment, including medical examination, in the manner established by order of the Ministry of Health and social development Of the Russian Federation of March 23, 2012 N 252n "On approval of the Procedure for imposing on a paramedic, a midwife by the head of a medical organization in the organization of the provision of primary health care and emergency medical care of certain functions of the attending physician for the direct provision of medical care to the patient during the period of observation and its treatment, including the prescription and use of drugs, including narcotic drugs and psychotropic drugs "(registered by the Ministry of Justice of the Russian Federation on April 28, 2012, registration N 23971).

10. The main tasks of a paramedic of a paramedic health center or a paramedic-obstetric station during a clinical examination are:

2) active involvement of the population in undergoing medical examination, informing about its goals and objectives, the scope of the examination and the work schedule of the departments of the medical organization involved in the medical examination, the necessary preparatory measures, as well as increasing the motivation of citizens to undergo medical examination, including by conducting explanatory conversations at the family level, organized team;

3) instructing citizens who have arrived for the prophylactic medical examination on the procedure for passing it, the volume and sequence of the examination;

4) performing pre-medical examinations of the first stage of clinical examination (survey (questionnaire) aimed at identifying chronic non-communicable diseases, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor's prescription, anthropometry, calculation of body mass index, measurement of blood pressure, as well as determination of total cholesterol and blood glucose levels by the express method, measurement of intraocular pressure by the non-contact method, examination by a paramedic, including taking a smear (scraping) from the surface of the cervix (external uterine os) and cervical canal for cytological examination)<1>;

<1> If you have the necessary equipment.

5) determination of risk factors for chronic non-infectious diseases on the basis of the diagnostic criteria provided for by Appendix No. 2 to this Procedure;

6) the formation of a set of documents, filling out the registration card for medical examination (preventive medical examinations) (hereinafter referred to as the registration card for medical examination) in the form approved in accordance with part 3

7) individual in-depth preventive counseling or group preventive counseling (patient school) on the referral of a therapist for citizens assigned to groups II and III of health status, as part of the second stage of clinical examination<1>;

9) informing citizens (aged 21 to 48 years) about the possibility of medical examination for HIV infection in accordance with the Federal Law of March 30, 1995 N 38-FZ "On preventing the spread in the Russian Federation of a disease caused by the human immunodeficiency virus ( HIV infection) "(hereinafter - Federal Law N 38-FZ) (Collected Legislation of the Russian Federation, 1995, N 14, Art. 1212; 1996, N 34, Art. 4027; 1997, N 3, Art. 352; 2000, N 33, Art.3348; 2004, N 35, Art.3607; 2007, N 43, Art. 5084; 2008, N 30, Art.3616; 2010, N 31, Art.4172; 2011, N 30, Art. 4590; 2013, N 27, Art. 3477; N 48, Art. 6165; N 52, Art. 6986; 2015, N 1, Art. 48; N 12, Art. 1801; 2016, N 1, Art. 58; 22, art. 3097) with the provision of addresses of medical organizations where it is possible to carry out voluntary, including anonymous, examination for HIV infection. (as amended by the Order of the Ministry of Health of the Russian Federation of 09.12.2016 N 946n)

11. The main tasks of the general practitioner during the clinical examination are:

1) drawing up lists of citizens subject to medical examination in the current calendar year, and a plan for conducting medical examination for the current calendar year, taking into account the age category of citizens;

2) active involvement of the population of the site in undergoing medical examination, informing about its goals and objectives, the scope of the examination and the work schedule of the departments of the medical organization involved in the medical examination, the necessary preparatory measures, as well as increasing the motivation of citizens to undergo medical examination, including by conducting explanatory conversations at the level of the family, organized team;

3) carrying out a medical examination of a citizen following the results of the first and second stages of clinical examination, establishing a diagnosis of a disease (condition), determining the relative total cardiovascular risk in citizens aged 21 to 39 years and the absolute total cardiovascular risk in citizens aged 42 up to 65 years of age, determination of a group of health status, a group of dispensary observation (taking into account the conclusions of medical specialists), prescribing the necessary treatment, in the presence of medical indications, referral to additional diagnostic tests that are not included in the scope of clinical examination, to obtain specialized, including high-tech, medical care, for spa treatment;

4) conducting a brief preventive counseling, including recommendations on healthy eating, physical activity, quitting tobacco smoking and harmful alcohol consumption; referral of citizens with identified risk factors for the development of chronic non-communicable diseases to the department (office) of medical prevention or health center, as well as a medical assistant's health center or a medical assistant-obstetric center<1> to provide medical assistance to correct these risk factors;

<1> For feldsher health posts and feldsher-obstetric points located in remote or hard-to-reach areas.

5) explaining to a citizen with a high risk of developing a life-threatening disease (condition) or its complications, as well as to persons living together with him, the rules of action during their development, including the timely call of an ambulance brigade;

6) participation in the preparation (maintenance) of medical documentation;

7) summing up the results of medical examination.

8) informing citizens (aged 21 to 48 years) about the possibility of medical examination for HIV infection in accordance with the Federal Law of March 30, 1995 N 38-FZ with the provision of addresses of medical organizations in which it is possible to carry out voluntary, including including anonymous, screening for HIV infection. (as amended by the Order of the Ministry of Health of the Russian Federation of 09.12.2016 N 946n)

12. The main tasks of the department (office) of medical prevention of a medical organization, including one that is part of a health center, during a clinical examination are:

1) participation in informing the population undergoing medical care in a medical organization about the conduct of medical examination, about its goals and objectives, conducting explanatory work and motivating citizens to undergo medical examination;

2) instructing citizens who have arrived for medical examination on the procedure for passing it, the volume and sequence of the examination;

3) performing pre-medical medical examinations of the first stage of clinical examination (survey (questionnaire) aimed at identifying chronic non-communicable diseases, risk factors for their development, consumption of narcotic drugs and psychotropic substances without a doctor's prescription, anthropometry, body mass index calculation, blood pressure measurement, level determination total cholesterol and blood glucose levels by the express method, measurement of intraocular pressure by a non-contact method);

4) determination of risk factors for chronic non-infectious diseases on the basis of the diagnostic criteria provided for by Appendix No. 2 to this Procedure;

5) the formation of a set of documents, based on the results of studies carried out as part of the clinical examination, for sending the patient for examinations by specialist doctors and a general practitioner based on the results of the first and second stages of medical examination, including filling out a medical examination record card;

6) registration of citizens who have passed each stage of medical examination, including filling out a medical examination record card and a report on conducting medical examination in the form approved in accordance with part 3 of article 97 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in Russian Federation";

7) individual in-depth preventive counseling or group preventive counseling (patient school) on the referral of a therapist for citizens assigned to groups II and III of health status, as part of the second stage of clinical examination;

8) explaining to a citizen with a high risk of developing a life-threatening disease (condition) or its complications, as well as to persons living together with him, the rules of action for their development, including the timely call of an ambulance brigade.

13. Clinical examination is carried out in two stages.

13.1. The first stage of clinical examination (screening) is carried out in order to identify signs of chronic non-infectious diseases in citizens, risk factors for their development, the consumption of narcotic drugs and psychotropic substances without a doctor's prescription, as well as to determine the medical indications for additional examinations and examinations by specialist doctors to clarify the diagnosis of the disease (state) at the second stage of clinical examination, and includes:

1) a survey (questionnaire) aimed at identifying chronic non-communicable diseases, risk factors for their development, the consumption of narcotic drugs and psychotropic substances without a doctor's prescription (hereinafter referred to as the questionnaire);

2) anthropometry (measuring standing height, body weight, waist circumference), calculating body mass index;

3) measurement of blood pressure;

4) determination of the level of total cholesterol in the blood (the use of the express method is allowed);

5) determination of blood glucose level by express method (laboratory method is allowed);

6) determination of the relative total cardiovascular risk in citizens aged 21 to 39 years and the absolute total cardiovascular risk in citizens aged 40 to 65 years old who do not have diseases associated with atherosclerosis;

7) electrocardiography at rest (for men over the age of 35, for women aged 45 and over, and for men under the age of 35 and women under the age of 45 - during the initial medical examination);

8) examination by a paramedic (midwife), including taking a smear (scraping) from the surface of the cervix (external uterine pharynx) and cervical canal for cytological examination (hereinafter - a smear from the cervix) (for women aged 21 to 69 years inclusive)<1>;

9) fluorography of the lungs<2>;

10) mammography of both breasts (for women aged 39 to 75)<3>;

<1> Except in cases where it is impossible to conduct a study for medical reasons due to extirpation of the uterus, virgo. Instead of being examined by a paramedic (midwife), it is allowed to be examined by an obstetrician-gynecologist, including taking a smear from the cervix. A cytological examination of a smear from the cervix is \u200b\u200bcarried out when staining a Pap smear.

<2> Fluorography of the lungs is not performed if the citizen underwent fluorography, radiography (fluoroscopy) or computed tomography of the chest organs during the previous calendar year or the year of the clinical examination.

<3> Except in cases when it is impossible to conduct a study for medical reasons in connection with a mastectomy. When a computed tomography of the mammary glands is carried out in the year of medical examination, mammography is not performed.

11) a clinical blood test (in the amount of not less than determining the concentration of hemoglobin in erythrocytes, the number of leukocytes and the erythrocyte sedimentation rate);

12) detailed clinical blood test (for citizens aged 39 years and older with a frequency of 1 time in 6 years instead of a clinical blood test);

13) a biochemical general therapeutic blood test (in the amount of at least determining the level of creatinine, total bilirubin, aspartate aminotransaminase, alanine aminotransaminase, glucose, cholesterol) (for citizens aged 39 years and older with a frequency of 1 time in 6 years instead of studies provided for subparagraphs 4 and 5 of this paragraph);

14) general urine analysis;

15) examination of feces for occult blood by the immunochemical method (benzidine or guaiac test is allowed) (for citizens aged 48 to 75 years);

16) ultrasound examination (hereinafter - ultrasound) of the abdominal cavity and small pelvis to exclude neoplasms for citizens aged 39 years and older with a frequency of once every 6 years (for women, ultrasound of the pancreas, kidneys, uterus and ovaries; for men, ultrasound pancreas, kidneys and prostate gland), and for men who have ever smoked in their life, also ultrasound of the abdominal aorta in order to exclude aneurysm once at the age of 69 or 75 years<1>;

<1> An ultrasound of the abdominal organs is not performed if a citizen has undergone magnetic resonance imaging or computed tomography of the abdominal organs within the previous 2 years or in the year of the medical examination.

17) measurement of intraocular pressure (for citizens aged 39 years and older);

18) reception (examination) of a general practitioner, including establishing a diagnosis, determining a group of health status, a group of dispensary observation, conducting brief preventive counseling, including recommendations on healthy eating, level of physical activity, cessation of tobacco smoking and harmful alcohol consumption, determination of medical indications for examinations and consultations as part of the second stage of clinical examination.

The first stage of clinical examination can be carried out by mobile medical teams, carrying out their activities in accordance with the rules for organizing the work of mobile medical teams provided for in Appendix No. 8 to the Regulation on the organization of the provision of primary health care to the adult population, approved by order of the Ministry of Health and Social Development of the Russian Federation of 15 May 2012 N 543n (registered by the Ministry of Justice of the Russian Federation on June 27, 2012, registration N 24726).

Citizens who, according to the results of the first stage of clinical examination, need additional examination, individual in-depth preventive counseling or group preventive counseling (patient school), are sent by a therapist to the second stage of medical examination.

13.2. The second stage of clinical examination is carried out with the aim of additional examination and clarification of the diagnosis of the disease (condition), conducting in-depth preventive counseling and includes:

1) duplex scanning of the brachycephalic arteries (if there is an indication or suspicion of a previous acute cerebrovascular accident based on the results of the questionnaire survey, as well as for men aged 45 and older and women aged 55 years and older in the presence of a combination of three risk factors for the development of chronic non-communicable diseases: high blood pressure, dyslipidemia, overweight or obesity);

2) esophagogastroduodenoscopy (if, according to the results of a questionnaire, complaints indicating a possible oncological disease of the upper gastrointestinal tract or for citizens over the age of 50 with burdened heredity for oncological diseases of the gastrointestinal tract are identified);

3) examination (consultation) by a neurologist (in case of indication or suspicion of a previous acute cerebrovascular accident based on the results of a questionnaire survey among citizens who are not under dispensary supervision on this matter, as well as in cases of primary detection of motor function disorders, cognitive impairments, etc. suspicion of depression in citizens aged 75 and over);

4) examination (consultation) by a surgeon or urologist (for men aged 42 to 69 years with the signs of the genitourinary system pathology revealed for the first time according to the results of the questionnaire survey or with burdened heredity for oncological diseases of the prostate gland, as well as for men, regardless of age in case of suspicion of prostate cancer based on the results of ultrasound);

5) examination (consultation) by a surgeon or a coloproctologist (for citizens with a positive fecal occult blood test, for citizens aged 45 years and older with burdened heredity for familial polyposis, colorectal cancer, if other medical indications are identified for the results of the questionnaire, as well as by appointment of a general practitioner, urologist, obstetrician-gynecologist in cases of detection of symptoms of colorectal cancer);

6) colonoscopy or sigmoidoscopy (in case of suspicion of an oncological disease of the colon, as prescribed by a surgeon or coloproctologist);

7) determination of the blood lipid spectrum (the level of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides) (for citizens with an identified increase in the total cholesterol level in the blood);

8) spirometry (for citizens with suspected chronic broncho-pulmonary disease based on the results of a questionnaire survey, smokers and on the referral of a general practitioner);

9) examination (consultation) by an obstetrician-gynecologist (for women with identified pathological changes based on the results of a cytological examination of a smear from the cervix and (or) mammography, ultrasound of the uterus and ovaries);

10) determination of the concentration of glycated hemoglobin in the blood or a glucose tolerance test (for citizens with an identified increase in blood glucose levels);

11) examination (consultation) by an otorhinolaryngologist (for citizens aged 75 years and older in the presence of medical indications based on the results of a questionnaire survey or examination by a general practitioner);

12) a blood test for the level of prostate-specific antigen (as prescribed by a surgeon or urologist for men with suspected prostate cancer based on the results of a survey, examination, digital examination or ultrasound of the prostate gland);

13) examination (consultation) by an ophthalmologist (for citizens aged 39 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 by spectacles, identified by the results of a survey);

14) individual in-depth preventive counseling or group preventive counseling (patient's school) in the department (office) of medical prevention (health center, medical assistant's health center or medical assistant-obstetric point) (for citizens with identified risk factors for the development of chronic non-infectious diseases who have these diseases or have high and very high absolute total cardiovascular risk);

15) reception (examination) of a general practitioner, including the establishment (specification) of the diagnosis, determination (specification) of the health status group, determination of the dispensary observation group (taking into account the conclusions of medical specialists), as well as referral of citizens in the presence of medical indications for additional examination, not included in the scope of medical examination, to receive specialized, including high-tech, medical care, for sanatorium treatment.

14. If a citizen has documented results of examinations (consultations) by specialist doctors (feldsher or midwife) (hereinafter - examination), research or information on other medical measures included in the scope of clinical examination in accordance with paragraphs 13.1 and 13.2 of this Procedure, which were performed in during the 12 months preceding the month of the medical examination, the decision on the need for a repeated examination, research or measures within the framework of the medical examination is made individually, taking into account all the available examination results and the state of health of the citizen.

15. If a citizen in the process of clinical examination reveals medical indications for examinations by specialist doctors, studies and activities that are not included in the scope of medical examination in accordance with this Procedure, they are appointed and performed taking into account the provisions of the procedures for the provision of medical care according to the profile of the identified or suspected disease (condition) and standards of medical care, approved in accordance with part 2 of article 37 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation", as well as clinical recommendations (treatment protocols) on the provision of medical care, developed and approved in accordance with part 2 of article 76 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation."

16. On the basis of information about a citizen's medical examination by a medical worker of a department (office) of medical prevention, as well as by a medical assistant of a medical assistant's health center or a medical assistant-obstetric station based on the results of studies carried out within the framework of a medical examination in this medical assistant's health center or a medical assistant-obstetric dispensary, a card is filled out. , which is filed in the outpatient medical record.

The results of other studies and examinations * not included in the clinical examination record are entered into the outpatient medical record marked "Dispensary examination".

17. The following criteria are used to determine, based on the results of prophylactic medical examination, a group of a citizen's health status and to plan the tactics of his medical supervision:

I group of health status - citizens who have not established chronic non-infectious diseases, there are no risk factors for the development of such diseases or there are specified risk factors with a low or average absolute total cardiovascular risk and who do not need dispensary observation for other diseases (conditions) ... Such citizens are provided with brief preventive counseling within the framework of clinical examination;

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

For such citizens, within the framework of clinical examination, correction of risk factors for the development of chronic non-infectious diseases is carried out (in-depth individual preventive counseling and (or) group preventive counseling) in the department (office) of medical prevention, health center, paramedic health center or paramedic-obstetric station, if there is a medical indication by a doctor - the therapist prescribes medications for medical use in order to pharmacologically correct the indicated risk factors. These citizens are subject to dispensary supervision by a doctor (paramedic) of the department (office) of medical prevention, as well as a paramedic of a paramedic health center or a paramedic-obstetric station<1>;

<1> For feldsher health posts and feldsher-obstetric points located in remote or hard-to-reach areas.

IIIa group of health status - citizens with chronic non-infectious diseases requiring the establishment of dispensary observation or the provision of specialized, including high-tech, medical care, as well as citizens with suspicion of the presence of these diseases (conditions) who need additional examination<1>;

<1> Based on the results of an additional examination, the group of a citizen's health status can be changed. If the patient has chronic non-infectious diseases and other diseases (conditions) requiring dispensary observation, he is included in the IIIa group of health status.

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

Citizens with IIIa and IIIb groups of health status are subject to dispensary observation by a general practitioner, specialist doctors with medical, rehabilitation and preventive measures. Citizens with IIIa group of health conditions, who have risk factors for the development of chronic non-infectious diseases, and citizens with IIIb group of health conditions, who have a high and very high total (absolute or relative) cardiovascular risk, are corrected for existing risk factors (in-depth individual preventive counseling and (or) group preventive counseling) as part of a clinical examination in the department (office) of medical prevention, a health center, a medical assistant's health center or a medical assistant-obstetric center<1>

<1> For feldsher health posts and feldsher-obstetric points located in remote or hard-to-reach areas.

18. The main criteria for the effectiveness of clinical examination of the adult population are:

1) coverage by prophylactic medical examination of the population who are under medical care in a medical organization and subject to prophylactic medical examination in this year (the planned value is at least 21% of the attached population); (as amended by the Order of the Ministry of Health of the Russian Federation of 09.12.2016 N 946n)

2) coverage of individual in-depth preventive counseling of citizens with II and IIIa group of health status, as well as citizens with group IIIb of health status, having high and very high total (absolute or relative) cardiovascular risk (planned value - at least 60% of those having medical indications for individual in-depth preventive counseling);

3) coverage by group preventive counseling (patient school) of citizens with II and IIIa groups of health status, as well as citizens with IIIb group of health status, having a high and very high total (absolute or relative) cardiovascular risk (planned value - at least 60 % of those with medical indications for group preventive counseling).

19. The medical organization keeps a record of citizens who have passed each stage of medical examination, with the registration of examinations, studies and other medical measures performed as part of the medical examination, and examinations, studies, activities previously performed outside the framework of the medical examination and taken into account during the medical examination in accordance with paragraph 14 of this Procedure, as well as refusals of citizens to undergo certain examinations, studies and events.

20. The first stage of clinical examination is considered completed and is payable within the framework of the territorial program of state guarantees of free provision of medical care to citizens (hereinafter - the territorial program) if at least 85% of the volume of medical examination established for a given age and gender of a citizen is completed, while it is mandatory conducting a questionnaire survey and receiving (examining) a physician - therapist.

In the event that the number of examinations, studies and other medical measures performed earlier and taken into account during the clinical examination in accordance with paragraph 14 of this Procedure exceeds 15% of the volume of medical examination established for the corresponding age and gender of the citizen, and the total volume of medical examination performed and accounted for in accordance with clause 14 of this Procedure for examinations, studies and other medical measures is 85% or more of the volume of medical examination, the first stage of medical examination is reflected in the report on the conduct of medical examination as a completed case, while only completed examinations (studies, measures) are payable in accordance with with the methods of payment for medical care established territorial program.

If less than 85% of the volume of medical examination established for a given age and gender of a citizen is performed within the framework of the first stage of medical examination, but at the same time, examinations, studies and other medical measures performed make up 85% or more of the volume of examination established for a preventive medical examination<1>, such cases are counted as a preventive medical examination carried out to a citizen.

<1> In accordance with the order of the Ministry of Health of the Russian Federation of December 6, 2012 N 1011n "On approval of the Procedure for conducting a preventive medical examination" (registered by the Ministry of Justice of the Russian Federation on December 29, 2012, registration N 26511)

The second stage of prophylactic medical examination is considered completed in the event of examinations, studies and other medical measures specified in clause 13.2 of this Procedure, the need for which is determined based on the results of the first and second stages of prophylactic medical examination.

DIAGNOSTIC CRITERIA FOR RISK FACTORS AND OTHER PATHOLOGICAL CONDITIONS AND DISEASES INCREASING THE PROBABILITY OF THE DEVELOPMENT OF CHRONIC NON-COMMUNICABLE DISEASES

Elevated blood pressure - systolic blood pressure equal to or greater than 140 mm Hg, diastolic blood pressure equal to or greater than 90 mm Hg. or antihypertensive therapy. Citizens with this risk factor include those with hypertension or symptomatic arterial hypertension (coded according to ICD-10<*> codes -), as well as citizens with high blood pressure in the absence of a diagnosis of hypertension or symptomatic arterial hypertension (coded according to ICD-10 code R03.0)

<*> International Statistical Classification of Diseases and Related Health Problems, 10 revisions

Dyslipidemia is a deviation from the norm of one or more indicators of lipid metabolism (total cholesterol 5 mmol / l or more; high-density lipoprotein cholesterol in men less than 1.0 mmol / l, in women less than 1.2 mmol / l; low-density lipoprotein cholesterol more 3 mmol / l; triglycerides more than 1.7 mmol / l) (coded according to ICD-10 code E 78).

Hyperglycemia - fasting plasma glucose level of 6.1 mmol / l or more (encoded by ICD-10 code R73.9) or diabetes mellitus, including if normoglycemia is achieved as a result of effective therapy.

Tobacco smoking is the daily smoking of at least one cigarette or more (coded according to ICD-10 code Z72.0).

Poor nutrition - excessive consumption of food, fats, carbohydrates, consumption of table salt more than 5 grams per day (salting of cooked food, frequent consumption of salted foods, canned food, sausages), insufficient consumption of fruits and vegetables (less than 400 grams or less than 4-6 servings per day). Determined by means of a survey (questionnaire) provided for by this Procedure (coded according to ICD-10 code Z72.4)

Overweight - body mass index 25-29.9 kg / m2, and more (coded according to ICD-10 code R63.5).

Obesity - body mass index of 30 kg / m2 or more (coded according to ICD-10 code E 66).

Low physical activity - walking at a moderate or fast pace for less than 30 minutes a day (coded according to ICD-10 code Z72.3)

The risk of harmful alcohol consumption (coded according to ICD-10 code Z72.1) and the risk of consuming narcotic drugs and psychotropic substances without a doctor's prescription (coded according to ICD-10 code Z72.2) are determined by means of a survey (questionnaire) provided for in this Procedure.

Complicated heredity for cardiovascular diseases is determined in the presence of myocardial infarction (coded according to ICD-10 code Z82.4) and (or) cerebral stroke (coded according to ICD-10 code Z82.3) in close relatives (mothers or sisters aged under the age of 65 or from the father, siblings under the age of 55).

Complicated heredity for malignant neoplasms - the presence of malignant neoplasms in close relatives at a young or middle age or in several generations (coded according to ICD-10 code Z80).

Complicated heredity for chronic diseases of the lower respiratory tract - the presence in close relatives at a young or middle age (coded according to ICD-10 code Z82.5).

Complicated heredity for diabetes mellitus is the presence in close relatives at a young or middle age (coded according to ICD-10 code Z83.3).

The total relative cardiovascular risk is established in citizens aged 21 to 39 years, the total absolute cardiovascular risk is established in citizens aged 40 to 65 years in the absence of identified diseases associated with atherosclerosis in the citizen. For citizens over the age of 65 and for citizens with cardiovascular diseases, type II diabetes mellitus and chronic kidney disease, the level of total absolute cardiovascular risk is very high and is not calculated on the scale of the total risk. When referring citizens to group II health status, only the value of the absolute total cardiovascular risk is taken into account.

In accordance with the order of the Ministry of Health of the Russian Federation of 13.03.2019 No. 124n "On approval of the procedure for conducting a preventive medical examination and medical examination of certain groups of the adult population", a preventive medical examination and medical examination of the adult population are carried out in the polyclinic.

You can get detailed information on the procedure and conditions for undergoing medical examination from the administrator, as well as from the department of medical prevention, the first-aid office.

For any questions that arise, you can contact the Right to Health Helpline 8-800-700-000-3 or the insurance medical organizationwhose address and telephone number are indicated on your compulsory health insurance policy.

Be attentive to yourself, take care of your health in a timely manner!

All-Russian clinical examination of the adult population is free, with the aim of early detection of chronic noncommunicable diseases, which are the main cause of disability and premature death.

Citizens undergo medical examination in a medical organization at the place of residence, work, study or the choice of a citizen, in which they receive primary health care - a territorial polyclinic.

The procedure for invitations to clinical examination changed last year. Now citizens are invited not only by medical institutions, but also by insurance medical organizations. They send SMS, invite by phone.

Your local doctor or local nurse or administrator will tell you in detail where, when and how you can undergo medical examination, agree with you on the approximate date (period) of medical examination.

All-Russian prophylactic medical examination takes place in two stages:

First step medical examination It is recommended to pass every three years for citizens from 18 to 40 years old, from 40 years old - annually. The examination of the first stage of clinical examination usually requires two visits. The first visit takes approximately 1 to 2 hours (the scope of the examination varies depending on your age). The second visit is usually carried out after 1-6 days (depending on the length of time required to obtain the research results) to the local doctor for a final examination and summing up the results of clinical examination.

If, according to the results of the first stage of clinical examination, you have a suspicion of the presence of a chronic non-infectious disease or a high and very high total cardiovascular risk, the district doctor informs you about this and sends you to second stage of clinical examination , the duration of which depends on the amount of additional examination you need.

FROM 1 June 2019 year came into force a new procedure for the medical examination of certain groups of the population.

What research is carried out at the first stage of clinical examination:

Survey, questionnaires (from 18 to 40 years old - 1 time in 3 years, from 40 years old - annually)

Measurement of height, weight, calculation of body mass index (from 18 to 40 years old - 1 time in 3 years, from 40 years old - annually)

Blood pressure measurement (once a year)

Determination of the level of total cholesterol in the blood (once a year)

Determination of blood glucose level (once a year)

Complete blood count (from 40 years old - once a year)

Fluorography of the lungs (once every 2 years)

ECG (from 35 years old - once a year)

Measurement of intraocular pressure (from 40 years old - once a year). This test is done to detect glaucoma.

Study of feces for occult blood by the immunochemical method (from 40 to 64 years inclusive - 1 time in 2 years,

from 65 to 75 years old inclusive - once a year)

Esophagogastroduodenoscopy (FGS) - at the age of 45

For men:

PSA test for men aged 45, 50, 55, 60, 64 years (screening test for diagnosing prostate cancer)

For women:

Examination by a paramedic-midwife (from 18 years old - once a year)

Taking a smear from the cervix and cervical canal for women (from 18 to 64 years old inclusive - 1 time in 3 years)

Mammography for women (from 40 to 74 years old inclusive - once every 2 years)

Each citizen who has undergone medical examination is issued a Health Passport, which contains the main conclusions (conclusions, recommendations) based on the results of the examination.

Regular medical examination will allow you to significantly reduce the likelihood of developing the most dangerous diseases that are the main cause of disability and mortality in our country, or identify them at an early stage of development, when their treatment is most effective

In 2020, citizens are subject to medical examination once every 3 years next years birth:

2002 (18 years), 1999 (21 years), 1996 (24 years), 1993 (27 years), 1990 (30 years), 1987 (33 years), 1984 (36 years), 1981 (39 years)

Citizens born in 1980 and earlier - are subject to medical examination annually .

Before undergoing medical examination, you can fill out a special form - this will save time at the appointment.

In 2019, citizens of all years of birth are subject to preventive medical examinations.

Regulations

Order of 11.06.2019 No. 160-osn "On conducting a preventive medical examination and clinical examination of certain groups of the adult population in 2019"

Additional materials
1. Memo 1st side .
2. Memo 2nd side.

Schedule of the department of medical prevention, Mira Ave. 46, office 1-17

1. Conducting preventive medical examinations and medical examination of the adult population on Saturday 2 times a month from 08.00 to 14.00 - 1st and 3rd week of each month.

1) The duty administrator instructs citizens who have come to preventive measures, after which he directs them to the duty doctor-therapist in room number 1-02;

2) The doctor on duty - the therapist (nurse) determines the volume of research required by a citizen as part of a preventive examination or clinical examination (taking into account the existing ones), conducts a questionnaire, anthropometry with the definition of BMI, measurement of blood pressure, HDI, ECG research, issues directions for research, necessary for the completion of a preventive medical examination or clinical examination of the adult population;

3) The duty administrator makes (if necessary) an entry in the MIS qMS in the examination room, for a mammographic examination, for a fluorographic examination, the entry is made through the terminal using direct recording with the issuance of a check;

4) Blood sampling is performed in the room. No. 2-20 from 8.00-14.00, feces analysis for occult blood is taken in the room. No. 1-11 from 8.00-14.00.

2. Conducting preventive medical examinations and clinical examination of the adult population by a team of specialists with the possibility of taking preventive measures in one day is carried out in accordance with the order of the chief physician of KGBUZ "KMP No. 5" dated 18.03.2019. No. 103-osn "On conducting clinical examination of certain groups of the adult population on Saturdays."

Where and when can I undergo an all-Russian clinical examination?

Citizens undergo medical examination in a medical organization at the place of residence, work, study or the choice of a citizen, in which they receive primary health care.

Your local doctor (paramedic) or local nurse or administrator will tell you in detail where, when and how you can undergo medical examination, agree with you on the approximate date of medical examination.

You can appear in person at the department of medical prevention or pre-medical office (Polyclinic №1, Mira Ave. 46)

You can also sign up by phone:

Polyclinic No. 1, Prospect Mira 46, call-center phone: 234-03-02

Polyclinic №3, st. Stepan Razin 35, call center phone: 234-03-03

Polyclinic No. 3, Center of ORP No. 1, st. Dmitry Martynov 31, call center phone: 202-63-06, 202-63-04

Polyclinic №3, Center of ORP №2, st. Dmitry Martynov 39, call center phone: 202-63-06, 202-63-04

Blood sampling, feces for occult blood are taken from 8.00-20.00, every day, except Saturday and Sunday.

Blood sampling, feces for occult blood are taken from 8.00-14.00 on the 1st and 3rd Saturday of each month.

Patient routing for preventive medical examination and clinical examination of the adult population:

Polyclinic number 4 st. Lenin 43

(from 8:00 to 20:00)

Registry

Offices of local therapists: No. 8; No. 12

1) Briefing

2) Questioning

3) Anthropometry

5) Examination based on the results of the DVN, issuance of a health certificate, referral for preventive counseling in the OMP: polyclinic No. 1, Mira Ave., 46, office. No. 1-17, Health Center: polyclinic No. 2, st. A. Lebedeva, 66, room number 25, stage II, according to indications.

Health center KSPU st. Ada Lebedeva 82

Office number 1-10

1) Briefing

2) Questioning

3) Anthropometry

4) Obtaining referrals for examinations of the I stage of the DVN

5) Examination by a physician therapist of polyclinic No. 4, office. No. 8, No. 12 with the issuance of a health passport, referral for preventive counseling in the OMP, polyclinic No. 1, Mira Ave., 46, office. No. 1-17, Health Center: polyclinic No. 2, st. A. Lebedeva, 66, room number 25, stage II, according to indications.

Health center KGII st. USSR Constitution 93

First-aid post

1) Briefing

2) Questioning

3) Anthropometry

4) Obtaining referrals for examinations of the I stage of the DVN

5) Examination by a physician therapist of polyclinic No. 4, office. No. 8, No. 12 with the issuance of a health passport, referral to preventive counseling in the OMP, polyclinic No. 1, Mira Ave., 46, office. No. 1-17, Health Center: polyclinic No. 2, st. A. Lebedeva, 66, room number 25, stage II, according to indications.

All-Russian clinical examination of the adult population

The main goals of clinical examination

Early detection of chronic noncommunicable diseases, which are the main cause of disability and premature mortality of the population of the Russian Federation, which include:

• diseases of the circulatory system and, first of all, ischemic heart disease and cerebrovascular diseases;
• malignant neoplasms;
• diabetes;
• chronic lung disease.

These diseases account for more than 75% of the total mortality of the population of our country.

In addition, clinical examination is aimed at identifying and correcting the main risk factors for the development of these diseases, which include:

• high blood pressure;
• increased blood cholesterol levels;
• elevated blood glucose levels;
• smoking tobacco;
• harmful alcohol consumption;
• poor nutrition;
• low physical activity;
• overweight or obesity.

An important feature of clinical examination is not only the early detection of chronic non-infectious diseases and risk factors for their development, but also the conduct of brief preventive counseling for all citizens who have these risk factors, as well as for persons with high and very high total cardiovascular risk of individual in-depth and group ( patient school) of preventive counseling.

Such active preventive interventions make it possible to quickly and significantly reduce the likelihood of developing dangerous chronic non-infectious diseases in each individual person, and in persons already suffering from such diseases, significantly reduce the severity of the disease and the frequency of complications.

How can a working person undergo medical examination?

According to Article 24 of the Federal Law of the Russian Federation dated November 21, 2011 No. 323-FZ “ Aboutfundamentals of Health Protection of Citizens in the Russian Federation ”employers are obliged to provide conditions for employees to undergo medical examinations and medical examinations, as well as to release employees without hindrance for their passage.

What preparation is needed to undergo medical examination?

• To undergo the first stage of medical examination, it is advisable to come to a medical organization (clinic) in the morning, on an empty stomach, before performing any physical activity, including morning physical exercises.
• Persons aged 40 and older are tested for occult blood. Currently, this study is carried out by the immunochemical method and does not require special training, including restrictions on food intake.
• On the container with feces, you must place a sticker with your name and initials.
• Women need to remember that the collection of smears from the cervix is \u200b\u200bnot carried out during menstruation, when carrying out one or another treatment of infectious and inflammatory diseases of the pelvic organs, that in order to reduce the likelihood of obtaining false results of smear analysis, it is necessary to exclude sexual intercourse within 2 days before medical examination, cancel any vaginal drugs, spermicides, tampons and douching.
• Men aged 45, 50, 55, 60 and 64 years old, when conducting a PSA test, must remember that it is better to refrain from any mechanical effects on the prostate gland for 7-10 days (rectal examination, prostate massage, enemas, riding horse or bicycle, sexual intercourse, treatment with rectal suppositories, etc.), as they can distort the result of the study of prostate-specific antigen in the blood (tumor marker of prostate cancer).
• If you underwent medical examinations in the current or previous year, take documents confirming this and show them to medical workers before starting a medical examination.
• The scope of preparation for the second stage of clinical examination will be explained to you by the local doctor.

What document does a citizen receive based on the results of medical examination?

Every citizen who has undergone medical examination is issued Health passport, which contains the main conclusions (conclusions, recommendations) based on the results of the survey.

Regular preventive medical examination and clinical examination will allow you to significantly reduce the likelihood of developing the most dangerous diseases that are the main cause of disability and mortality in our country, or to identify them at an early stage of development, when their treatment is most effective.

Analytical texts

Vaccination - the most effective way to protect yourself from influenza.

The flu virus is constantly changing, so every year a new vaccine is developed, purified, adapted to a new strain. After its introduction, the body produces protective antibodies that last for a year within 2 weeks.

• people over 60.
• persons suffering from chronic somatic diseases.
• persons who often suffer from ARVI.
• preschool children.
• staff medical institutions, workers in the social sphere, management, education, service, catering, transport, trade.
• military personnel, police, students.

There are also contraindications to vaccination:

1. Allergic reactions to chicken protein and other components of the vaccine.
2. Strong post-vaccination reactions (t above 40 C, the appearance of edema and hyperemia at the injection site\u003e 8 cm).
3. Post-vaccination complications (collapse, convulsions, anaphylaxis) for the previous vaccine.

There are also temporary contraindications:

1. Acute diseases with high fever.
2. Chronic diseases during an exacerbation.

Vaccination in 2019 is carried out from 09/01/19 to 11/11/19.

On the day of vaccination, each vaccinated person is examined by a physician. After vaccination, you must see a doctor after 30 minutes to rule out complications. During the week, do not overcool, do not overheat, exclude visiting the baths, swimming pools. Do not rub the injection site for 3 days. Redness, induration at the injection site is possible. Rise of t up to 37.0 C, headache. Do not drink alcohol within 2 weeks of the formation of immunity.

Preventing illness is easier than curing!

The main task

examination rooms are:

conducting a preventive examination of men and women with the aim of early detection of malignant tumors and precancerous diseases of visible localizations.

Tumors of external localizations, which can be detected during preventive examinations, account for 30% of all malignant tumors in both sexes and almost 40% in women.

In the examination room held pre-medical examination and examination of women and men from 18 years of age who first applied to a medical institution this year;

the skin, outer mucous membranes, lymph nodes, mammary and breast glands are examined.

In men and women, an examination of the rectum and external genital organs is carried out, with a collection of smears for cytology in women. Such an external examination makes it possible to detect malignant neoplasms on the skin and mucous membranes at an early stage. Women are sent for mammography.

Careful examination, oncological alertness and knowledge allow the medical assistant of the examination room to detect precancerous diseases and cancer.
It is now generally accepted that active detection of cervical cancer without cytological examination is impossible. The sampling of material for cytological examination is taken from all women without exception, regardless of the presence of complaints and examination data. If a pathology is suspected, the medical assistant of the examination room directs the patients to the appropriate specialist doctor for an in-depth examination.

Cancer screening is carried out for men and women over 50 years old in order to detect malignant neoplasms and includes:

• examination of the skin and visible mucous membranes;
• examination and palpation of the mammary glands (women), mammary glands (men);

examination and palpation:

• thyroid gland;
• belly;
• peripheral lymph nodes;
• external genital organs
• rectum

laboratory research:

• fluorography
• mammography (women);
• a detailed blood test;
• blood test for prostate-specific antigen PSI (men);
• examination of a smear from the cervical canal for atypical cells (women);
• study of feces for occult blood.

Routing