The doctor’s activity in the clinic is a combination of medical and preventive work. This also includes health education, vaccination, as well as medical examination. What the latter includes, what groups of patients are distinguished during it (general and dispensary registration groups for tuberculosis patients), we will analyze further.
What is a medical examination?
Dispensary method of work of a specialist, clinical examination is a dynamic active monitoring of the patient’s health. The method is primarily aimed at improving health, increasing the working ability of citizens, ensuring proper physical development in children and preventing disease prevention. The latter is achieved by a whole range of therapeutic, prophylactic and health-improving actions.
Who is included in the dispensary group? And healthy people, and those suffering from certain diseases, pathologies. How many dispensary care groups are in this category? Accordingly, two are sick and healthy. We will analyze them separately.
Healthy group
Consider the categories of persons included in this group of dispensary registration:
- Observed, whose state of health due to some physiological characteristics requires systematic monitoring by a specialist. As a rule, these are minors (children and adolescents), expectant mothers.
- Persons who are systematically exposed to harmful factors at work, at work.
- The so-called decreed contingent. This includes those employed in the food industry, employees of passenger, public transport, personnel of children's organizations, medical, public, preventive institutions, etc.
- Special contingent. For example, those affected by the accident at a nuclear power plant.
- Participants, invalids of the Great Patriotic War and persons equated to them.
The objectives of the clinical examination of this contingent are as follows:
- Identification of diseases and pathologies at an early stage.
- Preservation of health, working capacity (if relevant) of a citizen.
- Prevention of the development of diseases through timely treatment, prevention.
Group "sick"
This group of dispensary registration will include the following citizens:
- Reconvalescents after a series of acute diseases.
- Suffering from chronic diseases.
- Persons with genetic, congenital diseases, certain malformations.
The goals of the medical examination of the data of citizens are as follows:
- Early detection of pathologies and timely elimination of causes that may lead to their progression.
- Prevention of exacerbations, complications, relapses of the disease.
- Preservation of full longevity, return to work.
- Providing comprehensive qualified medical care as a way to reduce the threshold of morbidity, disability, mortality.
- Conducting rehabilitation, health-improving activities.
The main tasks of the clinical examination
Let's move from dispensary registration groups to the event itself. Its main tasks are as follows:
- Identification of risk groups for the development of a disease. This is achieved by conducting preventive medical examinations, which we will discuss further.
- Active monitoring of the risk group, improvement of these individuals.
- Dynamic observation of dispensary groups.
- Examination, treatment, rehabilitation according to the appeal of the patients themselves.
- Creation of automated systems, databases, helping to keep a full record of groups.
Medical preventive examinations
These activities are aimed at the following:
- Accounting, examination of patients, selection of contingent for certain groups of dispensary registration.
- Conducting a census on the site by a medical professional.
- A survey to assess the state of health, health of a citizen, determine the risk of developing a dangerous disease, pathology.
Types of medical examinations
Preventive medical examinations in our country are found in three varieties:
- Preliminary. They pass persons before starting their studies, work. The goal is to determine the suitability of a citizen for a particular job, to identify his contraindications to this activity.
- Periodic. Already carried out in a systematic, planned manner. In particular, such a physical examination is mandatory for workers at enterprises with dangerous and harmful working conditions, pregnant women, children and adolescents, school students, students of secondary and higher educational institutions, people exposed to radiation, participants, invalids of the Great Patriotic War and equivalent to them in the law of citizens.
- Targeted. The main task is the early, timely identification of a dangerous pathology. They are carried out in tuberculosis dispensaries, cancer centers, etc.
The main forms of medical examinations
Two categories can be distinguished here:
- Customized. Relevant when a citizen applies to a medical institution for issuing a spa card, for help, in connection with some disease. It is also a call of certain persons by the doctor to the clinic for a medical examination, examination of patients undergoing treatment in a hospital, having contact with infectious patients, etc.
- Massive. As a rule, they will be held among organized groups of people - school classes of children and adolescents, student groups, young men of pre-draft age, workers and employees of certain enterprises, organizations and institutions. They are complex in nature, can combine immediately targeted and periodic medical examinations.
Population health groups
Based on the results of a medical preventive examination, a citizen is determined by one of three observation groups:
- D1 - healthy citizens. These are people who have not been found to have serious diseases during the examination or in the anamnesis (medical history). Citizens who do not have complaints about their state of health.
- D2 - almost healthy. Who belongs here? Persons who have a history of chronic diseases that are not accompanied by exacerbations for several years. Having a borderline condition, referred to a risk group for any disease, pathology. Also having an acute infection or getting sick often and for a long time.
- D3 - chronic patients. Additionally, there are three categories of citizens. The first is with a decompensated course of diseases, with persistent pathological dysfunctions, which lead to disability, irreversible loss of performance. The second - with subcompensated development of the disease, frequent periodic exacerbations, prolonged loss of working capacity. The third - with a compensated course of the disease, infrequent exacerbations, short disability.
Dispensary registration groups for tuberculosis patients
There will be a different gradation from the general one. The following groups are allocated in a tuberculosis dispensary:
- Zero Diagnostic for children. For adults with tuberculosis of dubious activity.
- First one. The first detected disease. Relapse of tuberculosis.
- The second one. Chronic forms, chronic progression of the process.
- The third. Those who have been clinically cured of tuberculosis.
- Fourth. Persons permanently resident with a bacterial excretory.
- Fifth. Patients with extrapulmonary tuberculosis.
- Sixth. Children not vaccinated with BCG infected with MBT. Children who have complications after vaccination.
- Seventh. Patients with sarcoidosis.
We will analyze each of the groups in more detail.
Zero group
0 group dispensary registration of tuberculosis patients:
- Children who need to clarify the nature of sensitivity to tuberculin, determine the activity of tuberculous changes, the etiology of intoxication, damage to vital systems.
- Adults with tuberculous changes in a dubious mild stage.
First group
It is divided into additional subcategories:
- 1A - group dispensary accounting. Tuberculosis intoxication in children, first diagnosed with tuberculosis in adults.
- 1B - a group of patients with repeated tuberculosis.
- 1B - a group of patients with newly diagnosed, but ineffectively cured tuberculosis
Second group
There are two subcategories:
- 2A - a group of patients transferred from the 1st group due to the impossibility of a complete cure for the disease within 2 years. In this case, they did not reveal severe changes characteristic of a chronic disease.
- 2B group of patients transferred from the 1st category due to treatment failure. This group has already formed severe chronic changes in the respiratory system.
Third group
And again, doctors will distinguish two additional categories of patients:
- 3A - group dispensary accounting. These are individuals who are diagnosed with large residual changes, as well as small, but with a number of aggravating factors.
- 3B - a group of patients with small changes that are not accompanied by any aggravating factors.
Fourth group
The following categories of persons are distinguished here:
- Contacting with a bacteriostatic agent, an animal, a patient with tuberculosis.
- Contact with a person or animal suffering from tuberculosis.
- Children and adolescents who have been in contact with a patient with active tuberculosis without bacteria.
Fifth group
Forms of extrapulmonary tuberculosis:
- Zero group. A disease of dubious activity.
- 5A - a group of patients with newly diagnosed disease, relapse cured.
- 5B is a group of people with a chronic or progressive disease.
- 5B is a group of patients who have a history of a clinically cured disease that left behind large or small changes.
Sixth group
Observed children and adolescents fall into three categories:
- 6A - a group of patients with the so-called turn of tuberculin test.
- 6B - a group of patients with a hyperergic reaction, progression of tuberculin sensitivity.
- 6B - a group of unvaccinated BCG on time, having complications after vaccination.
Seventh group
There are three subcategories:
- 7A is a group of patients with active sarcoidosis.
- 7B - a group of patients with a relapse of the disease.
- 7B is a group of patients with a clinically treated disease.
Now you are familiar with the dispensary groups as part of preventive medical examinations. We also examined the gradation of patients registered in the dispensary for tuberculosis.