Total medical examination

General medical examination of workers will help doctors

The increase in healthcare spending not only made it possible to begin re-equipping district hospitals and building new high-tech medical care centers, but also brought mass medical examinations back to life. Yesterday, Minister of Health and Social Development Tatyana Golikova signed an order to conduct a total medical examination of working Russians insured in the compulsory health insurance system in 2008-2009. At the same time, the costs of examining everyone will be significantly increased. If in 2006 540 rubles were allocated for the examination of one person, including tests, then this year a health care institution (HCI) will receive 974 rubles from the FFOMS for conducting a full medical examination. In 2009, the amount of compensation is planned to be increased to 1042 rubles. This, in turn, will make it possible for the first time to significantly increase the salaries of medical specialists, who were bypassed during the recent increase in salaries for primary care physicians as part of the national project. According to estimates, the increase will practically equalize their earnings.

Let us remind you that in 2006 and 2007, some workers already underwent a routine medical examination, but only in the public sector - teachers, university professors, social workers, cultural workers, research institutes and doctors themselves (in total, according to data from the beginning of December last year, 7 .4 million people, or 74% of the planned state employees). In 2006, medical examination cost the state 1.6 billion rubles, and in 2007 - already 4 billion. It was planned that the costs of global preventive measures in the current and next years would remain at the same level - 4 billion rubles each. But, according to updated data, the 2008 medical examination budget will amount to 5.9 billion rubles, since the unspent balance of funds from last year will be added to it. According to preliminary estimates by the Ministry of Health and Social Development, about 6 million working citizens should take part in the program in 2008.

As part of the new medical examination, it will be possible to visit seven specialist doctors, undergo a variety of tests - from blood sugar to cholesterol levels (the older you are, the more) and have electrocardiography, fluorography, and for women over 40 years old - mammography. Among the specialists needed by working citizens are a therapist, a neurologist, an ophthalmologist, an endocrinologist, a surgeon and a urologist (for women, an obstetrician-gynecologist). It is also assumed that the laboratories of all medical institutions selected for the project will be able to test for the presence of two specific tumor markers - CA-125 (in women after 40 years) and PSI (in men after 40 years). This is the first mass examination, according to officials, that should provide early diagnosis of certain types of cancer.

As the Ministry of Health and Social Development explained to Vremya Novostei, visits to all doctors and laboratories should be completed within one working day, although test results may be ready later. Therefore, in the coming days, the department will issue another order that will determine how head doctors should organize medical examinations in their health care facilities. This document instructs to relieve specialists involved in medical examinations from other workloads, to place them in one corridor so that patients do not run around the floors, and to accurately maintain statistics of those examined.

Initially, the organization of this event was entrusted to the executive authorities of the constituent entities of the Russian Federation. At the moment, all of them have already requested data from local statistics departments about employers in their regions and the exact number of employees. And finally, we compiled a list of clinics that have the necessary set of equipment and specialists. Now all that remains is to notify the management of all, even the smallest enterprises, about where and when doctors are expected for their employees. The Ministry of Health promises that local health officials will not leave “deviators” alone. True, it is not yet possible to force anyone to participate in medical examinations. “We do not provide any sanctions for those who ignore,” Ekaterina Kokorina, deputy director of the department for the development of medical care and resort affairs of the ministry, told Vremya Novostey. According to her, employers should be interested in prevention themselves. Moreover, according to the new legislation, the employer pays for the first three days of temporary disability from his own pocket.

“It is not yet clear how all this will be organized. And everything should happen on a working day. But I think that most employers will go for it,” Igor Sergeenko, executive secretary of the commission of the Russian Union of Industrialists and Entrepreneurs on healthcare and medical industry, supported the official.

While the benefits of medical examinations may not seem obvious to some employers, they are clear to specialized government departments that distribute huge budgets. According to official statistics, over the previous two years, medical examinations helped identify more than 40 thousand cases of diabetes, 10 thousand cases of malignant neoplasms and 700 cases of tuberculosis. “If we talk about the effectiveness of any medical procedure, then it is assessed solely on the basis of the reduction in mortality that it gives,” argues the professor, deputy director of the Russian Oncology Research Center. Blokhina David Zaridze. - Clinical examination will not affect this indicator in any way, since those sections of society, due to which the level of this indicator in our country is off the charts, do not fall under it. And they were never covered by it, even in the USSR.”

Galina PAPERNAYA