Next year from the programme and examination plan to exclude a number of diagnostic procedures, as usual for many citizens. The innovation has caused intense public debate. “StarHit” recorded the views of opponents and supporters of reform.
In 2018 from the program of prophylactic medical examination will eliminate the urine and blood samples for patients older than 39 years, as well as ultrasound. The Ministry of health considers that the costs of the research in the absence of symptoms does not justify itself, doctors also worry that now the dangerous illnesses cannot be detected at an early stage. Who is right, discuss experts.
“FOR”: THE COSTS OF ANALYSES DO NOT JUSTIFY THE USE
In defense of innovations commented Sergey Boytsov, chief freelance specialist of the Ministry of health on preventive medicine.
“Clinical examination aims to identify not all of the disease, and those who are the cause of death – heart disease, cancer, chronic respiratory and diabetes. Urine and General blood these diseases do not show and do not have scientific evidence for the use of their screening (from the English. “mass study”) does not pass in any country in the world”, – the expert believes.
According to Boytsov, sometimes such studies can even harm the patient. “It happens that due to lack of specificity of the analysis the result is a suspicion of a serious disease – for example, Oncology. The patient from this news turns out to be in a stressful situation, and the hospital is spending huge financial and organizational effort to refute or confirm the result. In most cancer cases, fortunately, do not find. Screening science and practice, which proved their efficiency in dozens of countries. Since 2013, we have included in the program of clinical examination of the blood and urine tests, mainly to attract people to the usual methods of research,” he explains.
The expert notes that the health Ministry was forced to take the refusal of a number of diagnostic procedures. “Their costs do not justify the benefits – for example, to identify one case of chronic leukemia, you need to spend 500 million rubles, because the cost per analysis – 500 roubles, and the frequency you phenomena of each type of chronic leukemia – a million to one in each specific month. Therefore, these studies and ultrasound, we want to replace the fecal occult blood test, a more specific method, and a mammogram, which is under medical examination from 2018 it will be possible to do every three years, every two years, which will simplify the detection in the early stages of breast cancer and bowel,” says Sergei Fighters.
“Against”: NUMBER of PROCEDURES there are NO ALTERNATIVES
Nevertheless, the decision of the Ministry of health had to taste not all. Among those who believe this step is extremely neodnoznachnye, was the Deputy chief physician of the Moscow city clinical hospital No. 71 Konstantin Zverev. “I think delisting checked during medical examination tests a blood test is impractical, he said. – If we were talking about 25-year-old, the Ministry of health could be understood, but when we’re talking about people after 39 years… At this age, and older men have increased cholesterol, which leads to pathological changes, no clinical manifestations, but at the same time, which is a major factor of risk”.
The health Ministry stated that during the clinical examination of patients will pass other tests, capable to indicate the development of the disease. Zverev noted that it is not aware of any diagnostic procedures involved.
“Biochemical analysis of a fasting blood must be taken by all age groups – it just shows a person with diabetes. No other research this disease will not detected! General analysis of blood is also very informative – it indicates taking place in the body inflammation, speak to a doctor about the fact that human health need to check – including the presence of cancer. As for urine, it is also a disgrace – it is possible to diagnose pyelonephritis, which without treatment leads to threat of kidney failure”, – said the expert.
Zverev also said that I agree with those who do not consider a mandatory ultrasound examination. According to experts, it “not very useful”. “Detection rates with the help of serious pathologies is very small,” adds the worker to a medical institution.
According to experts, innovation can result in additional expenses for ordinary citizens. “People have to pass tests for their money. I’m talking about the conscious citizens worried about their health. What will happen to those who are not accustomed to go to doctors and for whom a routine clinical examination was the only reason to come to the clinic, even do not want to think…” – he said.