Today, there are a huge number of different pathological conditions. What unites them is that each of them is much easier to cure in the early stages of development. Identification of diseases immediately after their occurrence is the main goal of clinical examination.
Prophylactic examination - what is it?
Prophylactic medical examination is a complex of medical and diagnostic measures, which is aimed at maintaining the he alth of patients and preventing the development of diseases, including those of social importance.
Currently, every person has the opportunity to undergo a dispensary examination. Thanks to this, he has a chance to receive the necessary medical care in the early stages of the development of diseases. This is the main goal of medical examination of the population.
Why do I need medical examination?
Dispensary observation requires quite serious expenses from the Ministry of He alth. Despite this, those goals of clinical examination that are successfulachieved through such investments, fully justify any costs. The main goals are the following:
- Detecting diseases at the earliest stages of their development.
- Ensure regular follow-up of patients with chronic disease or an increased risk of its development.
- Carrying out preventive explanatory work with patients in order to correct their lifestyle.
- Prevention of the spread of socially significant diseases (for example, human immunodeficiency virus, tuberculosis).
Due to the achievement of the main goals of medical examination at the state level, it is planned to implement the following tasks:
- Decrease in the death rate of the population, especially in working age.
- Reducing the incidence of cardiovascular and other non-communicable diseases.
- Stopping the growth in the number of patients with socially significant diseases such as tuberculosis and HIV.
- Increasing the level of human interest in maintaining their own he alth.
- Ensure monitoring of the dynamics of chronic pathologies in order to reduce the number of exacerbations.
- Save budgetary funds by reducing the number of complex treatments needed to combat diseases in the advanced stages of their development.
If these tasks are achieved, we can expect an improvement in the socio-economic condition of the state in general and the he althcare system in particular.
Goalsdispensary observation of the child population
For this age category of patients, an increased frequency of dispensary examinations is expected. This is due to the high rate of changes occurring in the child's body.
The goals and objectives of clinical examination for young patients are the same as for adults. Features are as follows:
- the need to identify diseases as quickly as possible in order to normalize the socialization of patients;
- ensuring constant control over the pace of physical and mental development of the child.
Special attention is paid to medical examinations of minors. The availability of diagnostic and treatment procedures for them is much higher than for adults.
Who should be screened?
Today, the frequency of medical examinations depends on the presence of certain diseases in a person. Absolutely he althy people should apply for medical examination at least once a year. As part of such examinations, the patient is not only examined by doctors, but also undergoes laboratory and instrumental examinations.
In order to achieve the goals and objectives of clinical examination, patients with chronic diseases undergo medical examinations somewhat more often (usually 1-2 times a year).
For children, the frequency of visits to the doctor is somewhat different. They are very actively observed up to 1 year. Then it is necessary to undergo a medical examination at 3, 7, 10, 14, 15, 16 and 17 years. Thanks to such a thorough examination, it is possible to achieve the main goals of clinical examination inchildren.
Stages of dispensary observation
For the full implementation of the goals, the clinical examination is divided into the following stages:
- Performing patient screening.
- Carrying out additional diagnostic measures, establishing a diagnosis and prescribing a suitable treatment.
At the first stage, patients need to be examined depending on their age and the presence of chronic pathology. Absolutely all patients need to undergo the following diagnostic measures:
- complete blood count;
- biochemical blood test with determination of cholesterol levels;
- general urinalysis;
- blood glucose test;
- electrocardiography;
- fluorography;
- physical examination (height, weight, body mass index).
After the patient is 39 years old, he needs to undergo an ultrasound examination of the abdominal cavity organs, as well as the small pelvis, once every 6 years. In addition, women should undergo a mammogram and a gynecological examination. During this examination, a swab is taken from the mucous membrane of the vagina for subsequent cytological examination.
From the age of 40, the patient during medical examination also needs to visit an ophthalmologist to measure intraocular pressure. This allows timely detection of glaucoma, while maintaining a person's vision.
From the age of 48 each patient is offered withinmedical examination to take a stool test for occult blood. Such an examination makes it possible to detect precancerous and oncological diseases of the gastrointestinal tract at the earliest stages of development.
When the results of the examination are ready, the patient is sent for examination to the therapist. He studies the data of the diagnostic measures taken, specifies the weight, height of the patient, determines the body mass index and conducts a medical examination with the obligatory measurement of blood pressure. This concludes stage 1 of the dispensary. The purpose of its implementation is to identify deviations from the norm in patients. In the future, the 2nd stage of medical examination begins, which involves an in-depth examination of people with identified risks of development or signs of acute or chronic diseases.
About the second stage of clinical examination
This stage is no less important for the implementation of all the goals of medical examination of the adult population and children. Its main task is an additional examination of patients with signs of he alth problems or increased risks of developing pathological changes in the body. Thanks to this, the doctor has the opportunity to make a clinical diagnosis and prescribe the most effective treatment regimen. At this stage, the patient may be advised to undergo both the simplest and very complex types of diagnostic studies.
Special populations
There are several separate categories of citizens who can undergo dispensary observation annually, even if they do not have any pathology. Among them:
- face,victims of the disaster at the Chernobyl nuclear power plant;
- veterans of the Great Patriotic War and persons equated to them;
- warriors-internationalists.
As part of the dispensary examination, people from this category are recommended to undergo some additional examinations (for example, people affected by the Chernobyl accident should periodically undergo an ultrasound of the thyroid gland).
Dispensary examination results
There is a concept of medical examination efficiency. It implies not only taking into account the quantitative indicators of dangerous diseases detected at an early stage. The transfer of patients from one group to another is also important here. Effective is the dispensary observation that allows people from the group of patients with serious pathology to move into the category of people with long-term remission of chronic diseases or even completely he althy.
It is rational to assess the real assessment of the activity of a general practitioner in conducting medical examinations after at least 8-10 years of constant work with the same patients. Otherwise, the results will not be objective.
The role of the nurse
Medical workers are the main employees on whose activities the implementation of all the goals of medical examination directly depends. The nurse must keep a file of patients and ensure their active call for the next examination on time. The telephone is most often used for this purpose. Less often patientssend written notices by mail. If a person systematically does not come to the medical examination and at the same time has a serious illness that, without medical supervision, can lead to serious complications, then the nurse will visit the patient at home.
The task of the nurse is also to timely inform the doctor about the avoidance of patients from dispensary examination, as well as the presence of significant deviations from the norm in the results of their examination.
The role of the general practitioner
It is this doctor who is responsible for the implementation of the goals of medical examination. He coordinates the activities of the nurse, develops a scheme of therapeutic and rehabilitation measures, prescribes the additional examination necessary for the patient. As part of the observation, the doctor can independently set the frequency of examinations necessary for a particular person with chronic pathology. At the same time, their frequency should not be lower than prescribed in the regulations.
Also, the general practitioner analyzes the results of the ongoing medical examination, evaluates its effectiveness and develops measures to improve it.
Can I refuse medical examination?
Not all patients understand and are close to the goals of medical examination. Many try to avoid it. For those who do not wish to undergo a periodic examination, the following should be done:
- Contact your GP with a request for an opportunity to refuse to undergo dispensary examinations.
- Complete this application in writing.
- Fill out the form for refusing to undergo medical examination (it indicates the possible consequences for the patient and the absence of claims against medical workers).
This application is certified by the personal signature of the patient and the general practitioner. After that, medical workers will stop bothering the person with constant calls for a medical examination.
On socially significant diseases
Prevention of the development and spread of such dangerous diseases as HIV infection and tuberculosis is one of the main goals of medical examination of the population. This task is extremely important due to the fact that such diseases are of serious socio-economic importance. During the previous decade, the number of such patients has increased and continues to grow.
In order to prevent the spread of tuberculosis, patients are encouraged to undergo a fluorographic examination. The dose of radiation that a person receives during it is much less than when performing an x-ray. The same study makes it possible to detect tumor diseases of the lungs in the early stages of their development.
HIV infection can be suspected based on the results of a general blood test. Unfortunately, deviations in it are not visible at the very first stages of the disease. Therefore, patients who have had sexual contact with a person in whose he alth they are not sure are recommended to take a blood test for HIV infection. This can be done as part of the medical examination.
Foreign experience
Many countries have a similar system for monitoring patients. In states with a developed he althcare system, the level of monthly payments for medical insurance depends on the timeliness of examinations. Those who do not follow the recommendations of doctors have to pay an order of magnitude more.
A medical examination system similar to the Russian one is available in the Republic of Belarus. He althy patients undergo dispensary examinations there once every 2 years. The complex of diagnostic examinations is also comparable. At the same time, the main goal of medical examination of the population in this country is the same as in the Russian Federation.
