Medical examination of children

Medical examination

Main article Medical examination (complex check of health, check-ap)

2018

Instruction of the All-Russian union of insurers

The All-Russian Union of Insurers (ARUI) prepared in October, 2018 an instruction about features of passing of medical examination of minors according to the policy of compulsory health insurance in 2018 and also about what violations school students and their parents when passing medical examination can face.

The sudden death of school students in Russia in 70% of cases occurs during physical education classes. In a year it makes 1.4 death on 100 thousand children. Each of these cases could be prevented if in time the group of health of the child and level of allowable physical activities is defined.

Infographics Medical examination of minors

What is groups of health and for what they are defined?

Groups of health represent a scale by which the status of an organism and development of the child is determined. Groups were developed timely to provide to the child necessary medical care and also to determine the acceptable level of allowable intellectual and physical activity.

In total select 5 groups of health, and the group can change over time. Determinations of groups of health - one of the purposes of carrying out medical examination among minors.

How will medical examination be organized?

Since January 1, 2018 became effective the order of the Ministry of Health "About the Order of Performing Medical Examinations of Minors" N514n of August 10, 2017 according to which the order of performing medical examinations of children changes. There are no preliminary surveys before kindergarten and school any more. Now it is necessary to have only annual periodic examinations.

Medical examination of school students is planned by the medical organization (children's clinic) and carried out within academic year. Not later than 5 days prior to its carrying out the doctor is obliged to provide a design of the informed voluntary consent with indication of the list of surveys by specialists and researches and also time, date and the place of their carrying out and to hand it to the minor, the parent or the legal representative.

What surveys and researches are included into children's medical examination?

From 0 to 1 years:

From 1 to 4 years:

From 5 to 9 years:

From 10 to 14 years:

15-17 years:

In case of suspicion on presence at a minor disease (status) which diagnosis cannot be set when carrying out the surveys and researches included in the List of researches the doctor directs the minor to additional consultation and (or) a research.

Violations of the rights of the patient

What violations of the rights of the patient parents of minors most often face when passing medical examination on compulsory health insurance:

• Lack of the voluntary informed consent

The necessary precedent condition of medical intervention (including routine inspection) is giving the informed voluntary consent of the minor or his legal representative to medical intervention.

• Tightening of terms

Medical examination should not last more than ten working days. If to define the state of health of the child, additional consultations of doctors or a research were required, then the second stage of medical examination begins. Under the law the second stage of medical examination should not last more than 35 working days. Thus, the maximum duration of medical examination cannot exceed 45 days.

• Absence of specialists

In case of absence in the medical organization performing routine inspection of the minor, necessary specialist or instrumental, laboratory methods of inspection, this medical organization should provide to the child passing of the specified survey in other medical organization.

All surveys of specialists and diagnostic testings in other medical organization are provided free of charge according to the policy of compulsory health insurance. If at the parent it is impossible to settle an issue of free receiving medical service in the policy of compulsory health insurance with the manager of clinic, then it is necessary to address to the medical insurance company where the policy of compulsory health insurance is issued to the child.

• Illegal collection of payment for the surveys entering compulsory health insurance and a research

Medical examination of the child is included into the program of compulsory health insurance of compulsory health insurance, i.e. carried out free of charge.

If you faced the offer of paid medical services, tightening of terms of medical examination or at emergence of any other questions connected with the organization of diagnostics or treatment address an insurance representative in the medical insurance company which issued you the policy of compulsory health insurance. "Hot" lines for consultation of insured work round the clock.

What select groups of health?

The I group of health.

The healthy minors having normal physical and mental development, not having anatomic defects, functional and morfofunktsionalny violations.

The II group of health.

Minors:

• which have no chronic diseases (statuses), but
• there are some functional and morfofunktsionalny violations;
• the convalescents who especially had infectious diseases heavy and moderate severity;
• with the general delay of physical development in absence
• diseases of an endocrine system (low growth, lag on the level of biological development), with deficit of body weight or excess body weight;
• it is frequent and long having acute respiratory diseases;
• with physical defects, effects of injuries or transactions at safety of functions of bodies and the systems of an organism.

The III group of health.

Minors:

• having chronic diseases (statuses) in a stage of clinical remission, with rare aggravations, with the saved or compensated functions of bodies and the systems of an organism, in the absence of complications of the main disease (status);
• with physical defects, effects of injuries and transactions at compensation condition of functions of bodies and the systems of an organism which degree does not limit a possibility of training or work.

The IV group of health.

Minors:

• having chronic diseases (statuses) in an active stage and a stage of non-persistent clinical remission with frequent aggravations, with the saved or compensated functions of bodies and the systems of an organism or incomplete compensation of functions;
• with chronic diseases (statuses) in a remission stage, with the violations of functions of bodies and the systems of an organism requiring purpose of the supporting treatment;
• with the physical defects, effects of injuries and transactions with incomplete compensation of functions of bodies and the systems of an organism which entailed restrictions of a possibility of training or work

The V group of health.

Minors:

• having a serious chronic illness (statuses) with rare clinical remissions, frequent aggravations, continuously recidivous current, the expressed decompensation of functions of bodies and systems of an organism, the existence of complications requiring purpose of permanent treatment;
• with physical defects, effects of injuries and transactions with the expressed violation of functions of bodies and the systems of an organism and considerable restriction of a possibility of training or work.