Frequency of in-depth medical examination and preventive examinations

Currently, Russian citizens in the country's polyclinics can undergo 3 main types of preventive examinations – medical examination, in-depth medical examination and occupational examination.

Medical examination and preventive examination are fast, reliable, absolutely free ways to check your health, identify diseases and the risks of their occurrence in just 1-2 days in a polyclinic at your place of residence. This should become the norm and a useful habit of everyone, the same as brushing your teeth, washing your face and saying "hello" when you meet.

During medical examination, they are examined every 3 years up to 40 years (at the age of 18, 21, 24, 27, 30, 33, 36, 39 years), and then annually, having previously signed up for any day at the registry office or through the EDS. The employer is obliged to provide you with 1 paid day for this every 3 years, and then you will bring him a certificate confirming the medical examination (without a diagnosis and information about your health). You can come for an examination and not in the year of medical examination, but then it will be called a "professional examination", and the scope of the examination will be slightly less. According to your age, a list of examinations will be assigned (it is clearly defined and the same for any region), the older you are, the more (for example, plus tests for oncology). According to the results of the examination, the therapist or the doctor of the medical prevention office will explain everything to you: what are you sick with, what to be treated with, what habits to give up, whether it is necessary to reduce weight, etc.

Preventive examination is carried out for the timely detection of diseases and risk factors for their development, as well as for the detection of non-medical use of narcotic drugs and psychotropic substances. Medical examination is a broader complex of examinations, including oncological examination and admission of narrow specialists.
What procedures include professional examination and medical examination?
The annual professional examination among citizens aged 18 years and older includes the following activities:

• questionnaires to identify complaints, symptoms, identify risk factors for diseases, etc.;
• calculation of body mass index;
• blood pressure measurement;
• the study of the level of total cholesterol in the blood;
• determination of blood glucose levels.
  

Adult citizens aged 18 and over are also given a fluorographic examination of the lungs or a lung radiography once every two years. In patients aged 18 to 39 years, inclusive, once a year, the doctor determines the relative cardiovascular risk, women of this age group are examined by a paramedic (midwife) or an obstetrician-gynecologist.

Citizens under 35 years of age at the first appeal, and at the age of 35 and older, electrocardiography is additionally performed annually during occupational examinations, and intraocular pressure is measured for all persons over 40 years of age.
In patients aged 40 to 64 years inclusive, the absolute cardiovascular risk is determined annually, and after the age of 65 - the risk of osteoporosis, depression, heart failure, uncorrected hearing and vision disorders.
Medical examination is traditionally carried out in two stages.  At the first stage, for citizens aged 18 to 39 years, inclusive, once every three years, a professional examination, oncoscreening, a brief preventive consultation and an examination by a general practitioner are carried out. Citizens aged 40 to 64 years inclusive and patients aged 65 years and older once a year, in addition to these procedures, also do a general blood test.
At the second stage of medical examination, patients are offered to undergo additional examinations by doctors of a narrow profile, their diagnoses are clarified.

Medical examination and occupational examinations are regulated by the Order of the Ministry of Health of the Russian Federation No. 404n dated April 27, 2021 "On approval of the Procedure for preventive medical examination and medical examination of certain groups of the adult population"

In-depth medical examination (UD) is carried out to patients who have undergone a new coronavirus infection (NCVI) no earlier than 60 days after the disease in accordance with the Order of the Ministry of Health of the Russian Federation dated 01.07.2021 No. 698n "On approval of the Procedure for sending citizens to undergo in-depth medical examination, including categories of citizens undergoing in-depth medical examination as a matter of priority." This is necessary to identify complications of NCVI (postcovid syndrome in its various manifestations). First of all, patients at high risk of complications aged 65+ and having 2 or more chronic diseases (mainly diabetes mellitus, cardiovascular diseases and severe respiratory diseases) should undergo in-depth medical examination. UD has its own set of studies: everyone, without exception (Ietap), is measured by blood oxygen saturation, spirometry, general blood analysis, biochemical blood analysis (cholesterol, fats, ALT, AST, LDH, creatinine). With moderate and severe covid, a 6-minute walk test is performed, the concentration of D-dimer in the blood. If the patient's blood oxygen concentration is reduced and he walks a short distance in 6 minutes, then the patient automatically switches to the second stage of the UD, where he is given an ultrasound examination of the heart, as well as a computed tomography of the lungs. If the normal level of oxygen concentration in the blood is maintained, but deviations are detected during the 6-minute walk test, the patient is given an ultrasound examination of the heart as part of the IIITAP of in-depth medical examination. If the D-dimer values are elevated (microthrombs are present in the blood), then the veins of the lower extremities are additionally examined by ultrasound in order to detect blood clots as a risk of sudden death from blockage of these blood clots of the vessels of the head (ischemic stroke), heart (myocardial infarction) or lungs (pulmonary embolism). The data of the UD are entered into the outpatient card, and the attending (district) doctor takes preventive measures to prevent life–threatening situations (if the patient does not take basic therapy, the full volume of treatment of the underlying diseases is prescribed in combination with blood-thinning drugs and the frequency of further observation and examination is prescribed in each case individually).

We invite everyone to the examination!

I think that every literate person who is going to live happily ever after should do this!

Chief Medical Officer of GUZ
"Lipetsk city
Hospital No. 4 "Lipetsk-Med",
Agapova Yulia Refatovna