Examination: questions and answers

About risk factors

All chronic diseases develop gradually, but not from scratch. There are such conditions under which the probability of the onset of the onset of the disease increases. This is called risk factors. They can be identified long before the onset of the first symptoms of the disease. Correction with the help of medicines, nutrition, physiotherapy exercises and other instrumental medical methods makes it possible to reduce well and, in some cases, completely prevent the development of the disease.

It is much easier and cheaper to identify risk factors, rather than to carry out the belated diagnosis and treatment of the disease. The identification of risks helps to cure more effectively and quickly and to achieve full recovery.

What is it?

Clinical examination is a complex of activities conducted for the earliest possible detection of any chronic non-communicable diseases, which are the main cause of premature mortality and disability.

Why is it needed?

Examination of the adult and children's population allows finding the risk factors for cancer, cardiovascular diseases, endocrine system diseases whose risk factors include inadequate nutrition, obesity, excessive consumption of alcohol-containing beverages, tobacco smoking, low physical activity, high cholesterol and elevated levels of arterialpressure.

Is there a paid procedure for medical examination?

No, this is a free procedure, its payment is made by means of compulsory medical insurance.

Do you need to go to a specialized institution for medical examination?

No, you do not. The dispensary is organized according to the precinct principle, that is, every citizen has the right to undergo this preventive examination in his district polyclinic at the place of residence( permanent or temporary registration).

Do people working or not work for dispensary?

Dispensary is subject to 3 main categories of citizens:

1. working citizens,
2. non-working citizens,
3. citizens studying in educational institutions.

Clinical examination of adolescents and children is carried out according to a separate program. And here you can read about the peculiarities of medical examinations for orphans.

Do you need to undergo medical examination every year?

Of course not, it is held once every three years. The first comprehensive examination at 21 years, then every three-year interval. In 2018, citizens of certain ages will undergo medical examinations.

Can a citizen refuse to have a medical examination?

For the DVN, informed voluntary consent is necessary, and the citizen has the right to issue a refusal from the whole medical examination or from certain types of medical research that are included in its scope. The refusal must be in writing and correspond to the procedure, which is approved by the federal legislation. And, if a citizen refuses actions exceeding 15% of the number needed, then this is not a clinical examination, but a preventive examination.

Who did not go through the OWN will be punished?

No. After all, this is the personal choice of everyone. Care for one's health is the prerogative of the citizen himself. The state provides an opportunity to receive free information about health, prevent the emergence of chronic diseases, identifying and reducing the impact of risk factors, begin treatment of present diseases in the early stages.

An employer can force a worker to send a DVN?

Coercion is illegal. You can not force the employee to undergo prophylactic medical examination of the adult population. At the same time, the employer should be interested in reducing the incidence of his charges, because this increase in the number of working days instead of sheets of incapacity for work.

How to pass the OWGN to those who work?

On the basis of Article 24 of the Federal Law No. 323-FZ "On the Basics of Health Protection of Citizens", the employer is obliged to provide conditions for workers to undergo medical examinations and medical examinations and to freely let workers go through them.

If the employer needs confirmation that the employee was actually on a preventive examination, a certificate is issued at the place of his passage indicating the time spent on his passing.

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What do I need to do DVN?

At the time of clinical examination in the polyclinic registry you need to show your passport, medical insurance policy and SNILS.

How long does it take to receive medical examinations?

It is carried out in two stages.

Passage of examinations of the 1st stage of clinical examination requires a minimum of two visits to the polyclinic. The first will roughly take time from three to six hours( this depends on the amount of medical examinations appropriate to your age).The second visit to the district physician-therapist for the final examination and summarizing the results of the medical examination( depending on the time needed to obtain the results of the surveys) can take place in the range of one to six days.

If for any reason you have a chronic non-infectious disease or a high or very high total cardiovascular risk for the first stage, then the district therapist will send you to the second stage of medical examination, its duration depends on the amount of additional research.

What can be included in the first stage of medical examination?

1. Surveys( questionnaire) for the identification of chronic diseases, risk factors for their development, consumption of narcotic and psychotropic substances.
2. Anthropometric study( measurement of height, weight, waist circumference), calculation of body mass index, by which it is judged whether there is obesity and its degree.
3. Fixation of the blood pressure level.
4. Determination of total cholesterol( risk of cardiovascular disease).
5. Carrying out an electrocardiographic study.
6. Fluorography of the chest.
7. Survey of women with a gynecologist and mammography( for those over 39 years old).
8. Ultrasound examination of abdominal organs( for 39-year-old women and older once in 6 years).
9. Measurement of IOP( intraocular pressure)( a test for the risk of glaucoma in 39-year-old patients and older).
10. Consultation of a neurologist( from 51 years of age once in 6 years).
11. Clinical blood test( determination of the level of hemoglobin, leukocytes, etc.).
12. Measurement of blood glucose( risk of developing diabetes).
13. Biochemical blood test.
14. General analysis of urine.
15. Study of feces for the presence of hidden blood( for 45-year-old patients and older).
16. Measurement of the prostate-specific antigen level in the blood in men over 50 years for early diagnosis of prostate cancer.

Following the results of the 1st stage of DVN, the therapist determines the group of health and draws conclusions about the need for detailed examination.

Medical research and consultations conducted in the second phase of the MOLD?

1. In cases of predisposition to a stroke( high blood pressure, high cholesterol, excessive weight), duplex scanning of brachycephalic arteries is prescribed, appointed by a neurologist or a therapist to men over 45 and women over 55.
2. In cases of patients' complaints when questioning for abnormalities from the digestive tract, evaluated by the doctor as a risk of oncological disease( and especially when cancer cases were in the patient's parents), esophagogastroduodenoscopy is prescribed.
3. Inspection by a urologist or surgeon - with complaints and abnormalities in tests for possible diseases of the prostate gland.
4. Advising a surgeon or coloproctologist with the appointment of a colonoscopy or sigmoidoscopy( for those over 45 years of age).
5. Blood lipid profile - for those who have an elevated cholesterol level;determination of the concentration of glycated hemoglobin or a test for glucose tolerance( in cases when the first stage revealed an increase in glucose levels).
6. Advising a gynecologist.
7. Advising an ophthalmologist( with increasing intraocular pressure).

Health groups?

All patients, according to the current legislation of the Russian Federation in the field of medicine and depending on their state of health, are divided into different groups. This definition of the health group is necessary for planning the formation of tactics of medical supervision, including therapeutic and preventive measures.

These groups of health stand out:

1. The first group is the citizens with unidentified chronic non-infectious diseases, which are the main cause of disability, premature mortality. They have no risk factors or risk factors with low or average total cardiovascular risk. These citizens do not need regular follow-up for other diseases. They are given short preventive counseling, correction of risk factors by a therapist, a paramedic of a medical prevention office.
2. The second group is citizens with unidentified chronic noncommunicable diseases, the main cause of disability, premature mortality, risk factors for chronic noncommunicable diseases and high or very high total cardiovascular risk. They do not need constant follow-up care for other conditions. For these citizens, risk factors for chronic non-infectious diseases are corrected in the medical prevention office or health center. If they need to prescribe medications for medical use for pharmacological correction of risk factors. In this case, they are dispensively observed in the doctor or paramedic of the office( unit) of medical prevention.
3. The third group is people with illnesses that require dispensary supervision or the provision of specialized( including high-tech) medical care, as well as persons suspected of a disease that requires additional examination. After the end of the examination, these people may change their health. These people are dispensively observed in the therapist and other specialist doctors with the provision of preventive, rehabilitation and therapeutic measures.

How is the medical examination completed?

At the end of all consultations of specialists and medical studies, the patient visits a therapist who determines his health group and makes individual recommendations. If there are some diseases( eg, diabetes mellitus is diagnosed), the patient is sent to the patient's school for the purpose of group counseling.

The results of the medical examination can be recorded in the health certificate and issued to the patient on hand.

Difference between medical examination and preventive medical examination?

Prophylaxis is an abbreviated medical examination program. It can be held once every two years. The year of prophylactic medical examination cancels preventive examination.

For its passage, you need to contact the office( office) of the polyclinic at the place of residence.

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What if there is no necessary specialist in the polyclinic or equipment for examination?

In these cases, the head physician of the hospital enters into an agreement with another medical institution and gives a referral to it to complete the medical examination.