Decree No. 70 / 2012 Coll.
Order on preventive inspections
Valid
Effective from 01.04.2012
70
DECLARATION
of 29 February 2012
on preventive inspections
The Ministry of Health provides, pursuant to Section 120 of Act No. 372 / 2011 Coll., on health services and the conditions for their provision (Health Services Act), for the implementation of Section 5 (3) (a) of the Health Services Act:
Types of preventive inspections and providers carrying them out
(1) Types of preventive inspections are preventive inspections in the field
(a) general medical practice ("general preventive examination");
(b) practical medicine for children and adolescents ("general preventive examination of children"),
(c) dental medicine (dental preventive examination);
(d) gyno and obstetrics ("gynecological preventive examination").
(2) Provider carrying out a preventive inspection by:
(a) paragraph 1 (a) is a registered provider of outpatient care in the field of general medical practice;
(b) paragraph 1 (b) is a registered provider of outpatient care in the field of practical medicine for children and adolescents;
(c) paragraph 1 (c) is a registered provider of outpatient care in the field of dental medicine;
(d) paragraph 1 (d) is a registered provider of outpatient care in the field of gyno and obstetrics.
Content and time range of general preventive inspection
A general preventive examination shall be carried out every two years, as a rule after 23 months after the last general preventive examination. The contents of the general preventive inspection are:
(a) complementing the history, including social, focusing on its changes, risk factors and occupational risks; a family history of particular emphasis is placed on the occurrence of cardiovascular and pulmonary diseases, the incidence of hypertension, diabetes mellitus, disorders of fat and cancer metabolism, other hereditary diseases, and the incidence of mental illness and addiction,
(b) control of the vaccination carried out with a focus on the regular vaccination to the extent provided for by the legislation governing vaccination against infectious diseases (1), as well as on the recommended vaccination according to an individual risk assessment;
(c) checking the completion of gynaecological preventive examination, screening programmes and early detection programmes for serious diseases covered by public health insurance, which are the screening of colorectal carcinoma, breast screening, early prostate cancer programme, early lung cancer programme, early abdominal aortic aneurysm programme, early osteoporosis programme and early dementia programme; if these tests have not been carried out within the prescribed time limits, the patient's recommendation to complete them and to inform the patient of the risks associated with their rejection or failure to pass them;
(d) complete physical examination, including blood pressure measurement, determination of the body mass index and the circumference of the waist, and indicative examination of vision and hearing; Part of the general preventive examination is the oncological prevention of risk assessment in terms of family history, personal and occupational, skin examination and in the suspected risk of prostate cancer per rectum, in men with a positive family history or other risk factors for testicular clinical examination, in women from 25 years of age with a positive family history for hereditary or familial incidence of breast cancer or other risk factors for breast clinical examination, together with self-investigation instruction; for persons with a specified oncological risk, the preventive examination shall include an examination of whether the person is being monitored or whether he has been examined at the relevant specialised workplace or, where appropriate, the provision of such a specialised examination;
(e) a urine examination using a diagnostic paper, unless indicated by a laboratory urinalysis chemically;
(f) an ECG test for the first general post-care preventive examination with a provider of care, a general practitioner for children and adolescents, or the first post-registration preventive examination with a new general medical practitioner (hereinafter referred to as the entry general preventive examination) for persons with risk factors for cardiovascular disease at 30 years of age and at four years of age and from 40 years of age at two years of age; in persons without risk factors for cardiovascular disease at 40 years of age and at four-year intervals from the last examination,
(g) in an initial general preventive examination, a comprehensive laboratory examination where no current results are available, such as blood count, liver tests, blood glucose, serum creatinine, estimated glomerular filtration, urine chemically and sediment, the ratio of albumin to creatinine in the current urine (ACR), as well as total cholesterol, HDL-cholesterol, LDL-cholesterol and triacylglycerol (lipidogram); in the case of identified individually increased risk of selected diseases, the frequency and scope of individual laboratory tests for further preventive examinations shall be governed by current expert recommendations;
(h) checking and evaluating the results of other prescribed preventive laboratory tests from the available medical documentation and, if not carried out within the prescribed time limits, ensuring them; in the case of identified individually increased risk of selected diseases, the frequency and extent of individual laboratory tests for further preventive examinations shall be determined in accordance with current expert recommendations; preventive investigations shall be:
1. lipidogram at 25 and 30 years of age, and at four-year intervals since the last examination, at 40 years, and at two-year intervals since the last examination, laboratory tests for lipoprotein (a) at the initial general preventive examination have not been performed in the past with the result available from the medical file; in women, repeat the lipoprotein (a) test after menopause;
2. laboratory tests for blood glucose at two-year intervals and laboratory tests for blood counts at the initial general preventive examination at 25 and 30 years of age, and four-year intervals from the last examination, 40 years and two-year intervals from the last examination;
3. in persons with risk factors for chronic liver disease, laboratory tests for liver function (ALT, AST, GMT, bilirubin) from 45 years of age at two-year intervals;
4. a laboratory examination of the albumin / creatinine ratio in current urine (ACR), a laboratory examination of serum creatinine and an estimate of glomerular filtration in patients with diabetes, hypertension or cardiovascular disease and in all subjects over 50 years of age at 2-year intervals;
5. testing NT- for BNP in subjects with at least two risk factors for heart failure at 50 years and further at two years, in persons with at least one risk factor for heart failure at 60 years and further at two years; NT- for BNP testing will not be performed in a patient who is already dispensed for heart failure or is in the care of a cardiologist or other specialist.
(i) in patients aged between 45 and 61 years, recommendations for preventive eye examinations by the outpatient care provider in ophthalmology at four-year intervals;
(j) evaluation of physical and laboratory findings, diagnostic summaries, evaluation of individual cardiovascular-metabolic-renal risk of the patient, possible inclusion in the dispensarisation, possible design of individual treatment, including treatment regime and management of chronic diseases, design of recommended vaccination and guidance of the patient.
Content and time range of general preventive examination of children
(1) The content of general preventive examinations of children between birth and 18 months of age is
(a) the establishment of medical documentation when the child is taken into custody;
(b) the history and findings of changes in health since the last inspection;
(c) physical examination of which it is part
1. the determination of the weight, the length of the child and the circumference of the child's head, the evaluation of these parameters by growth charts;
2. internal examination,
3. examination of psychomotor development,
4. targeted age-specific examination and identification of health risks including the risk of child abuse, neglect and abuse;
(d) diagnostic balance sheet;
(e) the conclusion and guidance of parents on child nutrition and regime, including age-specific accident prevention;
(f) psychotherapeutic conversation with a parent, if it is a child with medical conditions or a child at risk of medical conditions, including health disorders, as a result of adverse family or other social conditions;
(g) control of the vaccination of the child and, where appropriate, the addition of the missing vaccination, to the extent provided for by the legislation governing vaccination against infectious diseases (1), a lesson on the possibility of further vaccination recommended for age, including both paid and not covered by public health insurance (2).
(2) It also contains a general preventive survey
(a) newborns, which are usually carried out first within 2 days of their release from a medical establishment in which health services in connection with childbirth have been provided, if possible in its own social environment;
1. assessment of the child's social environment, family history, maternal personal and pregnancy history, prenatal, perinatal and postnatal history and assessment of the medical report on the newborn,
2. examination of the general condition of the child, examination of the skin and subcutaneous layer, hair and nails, examination of the lymph nodes, muscles and skeletons, the head including the shape, the size of the fountain and the measurement of the circumference of the head, further examination of the eyes and their surroundings including the position of the eyeballs and conjunctivitis, examination of the ears, nose, mouth cavity, neck, chest, and the shape and condition of the clavicle bones, physical finding of the heart and lungs, examination of the abdomen including its size, palpaving examination of the internal abdominal organs, and umbilification of the hip joints, and examination of the psychomotric,
3. verification of the screening of the hearing of the newborn; if this examination has not been carried out, recommendations for its execution, including the submission of information on the health service providers carrying out the examination;
4. control of the preventive administration of vitamin K and guidance on the recurrence of preventive administration in indicated cases;
5. Lessons on preventive vitamin D administration,
6. the control of the questionnaire on the definition of tuberculosis risk and the recommendation of a follow-up procedure under the Ordinance on vaccination against infectious diseases,
7. learning about care for the newborn in health and illness, the basics of handling the newborn,
8. the lesson on breast-feeding or artificial milk nutrition,
(b) children at 14 days of age, except for the examinations referred to in point (a) (2), the finding of child nutrition, the monitoring of the initiation of preventive administration of vitamin D against curvature, the necessary instruction of the child's parent and the recommendation of a professional hip orthopaedic examination between the third and sixth week of age;
(c) children of 6 weeks of age, other than those referred to in (a) (2), checking the outcome of the orthopaedic examination and checking the preventive administration of vitamin D, an indicative visual examination;
(d) children of 3 months of age, except for the tests referred to in (a) (2), check for preventive administration of vitamin D;
(e) children between 4 and 5 months of age, except for the examinations referred to in (a) (2), an indicative examination of vision and hearing, an examination of the storage of testicles in boys and a lesson on child nutrition;
(f) children of 6 months of age, except for the examinations referred to in point (a) (2), checking the preventive administration of vitamin D, checking the development of teeth and instructing the parent of the need to register the child with a dental practitioner in the second half of the life of the child and its involvement in regular dental examinations;
(g) children of 6 to 12 months of age with visual examination, early detection of severe eye defects as part of the screening programme, in case of unclear or negative outcome of a control test 6 months after the date of the first examination but up to 18 months of age, in case of a positive family history, the examination shall be repeated at 2 and 3 years of age of the child;
(h) children of 8 months of age, except for the examinations referred to in (a) (2), an indicative examination of vision and hearing;
(i) children between 10 and 11 months of age, except for the tests referred to in (a) (2), control of the preventive administration of vitamin D;
(j) children of 12 months of age, except for the examinations referred to in point (a) (2), the detection and evaluation of essential anthropometric indicators, the control of the preventive administration of vitamin D, the determination of the size of the large fontanel, the examination of vision and hearing, speech and teeth development and the necessary instruction of the child's parents, information on oral hygiene, individual consideration of the total intake of fluoride, the recommendation of dental examination,
(k) children of 18 months of age, in addition to the examinations referred to in point (a) (2), the control of the condition of the large fontanel, the development and state of the teeth, including the recommendation of dental examination, the examination of vision and hearing, the assessment of psychomotor development with a focus on gross and fine motor, the development of speech and social behaviour of the child, the carrying out of the examination for the early capture of autistic spectrum disorders, in the event of a ambiguous outcome of the examination of the recommendations for the early detection of autistic spectrum disorders, 6 months after the date of the first examination.
(1) The content of general preventive examinations for children aged 3 years is
(a) an interview with a parent focused on new anamnestic facts, a check on the vaccination of the child or, where appropriate, the addition of a missing vaccination, to the extent provided for by the legislation on vaccination against infectious diseases (1), a lesson on the possibility of further vaccination recommended for age, including both paid and not covered by public health insurance (2);
(b) assessment of psychosomatic development, fine and coarse motor skills, social behaviour, communication skills and hygiene habits of the child;
(c) the determination of weight and height, the evaluation of these parameters by growth charts, in order to detect possible malnutrition, overweight or obesity;
(d) complete physical examination, including skin inspection and the exclusion of signs of abuse, neglect and abuse of the child;
(e) eye and eye examination;
(f) examination of speech, voice and hearing;
(g) indicative tests for laterality and colour resolution;
(h) urine examination using diagnostic paper;
(i) blood pressure and pulse tests;
(j) oral examination and, where appropriate, dental examination recommendations;
(k) genital examination and, for girls, detection of any effluent;
(l) the final interview of a doctor with a parent aimed at obtaining active cooperation, teaching parents about nutrition and the regime of the child, including accident prevention according to the specificities of the age, possibly a supportive psychotherapeutic interview, in particular when it comes to a seriously ill child, an endangered child and family functionality issues.
(2) In addition to the operations referred to in paragraph 1, the content of general preventive examinations for children aged 5 years or older is:
(a) the determination of weight and height, the determination of the weight ratio and the assessment of the growth of the child according to growth charts, in order to detect possible malnutrition, overweight or obesity, the evaluation of psychomotor development and communication capabilities for a preliminary assessment of school maturity;
(b) examination of colour knowledge with the requirement of their separate word marking;
(c) checking the hygiene habits of the child with a focus on urination;
(d) a history of ischaemic heart disease, myocardial infarction, angina pectoris, sudden stroke or hyperlipoproteinaemia up to 55 years of age and other risk factors,
(e) the submission of information on the examination of the hearing of the child by tone audiometry, including the submission of information on the health service providers carrying out the examination.
(1) The content of general preventive examinations of children at 7, 9, 11 and 13 years of age is
(a) an interview with a parent focused on new anamnistic facts, including targeted questions aimed at early detection of diseases and conditions that are initially showing unclear symptoms; the exclusion of signs of child abuse, neglect and abuse, the onset of various dependencies and the risk behaviour of the child; assessment of the social behaviour of the child and of communication capabilities; information on healthy lifestyle including age-specific accident prevention, family performance assessment,
(b) control of the vaccination of the child or, where appropriate, the addition of a missing vaccination, to the extent provided for by the legislation governing vaccination against infectious diseases (1), a lesson on the possibility of further vaccination recommended for age, including both paid and not covered by public health insurance (2);
(c) the identification of the weight and height of the child, the identification of the body weight index and the assessment of the growth of the child by growth charts, in order to detect possible malnutrition, overweight or obesity;
(d) complete physical examination including movement apparatus, skin examination, lymph nodes, thyroid glands and secondary genital characteristics;
(e) urine examination using diagnostic paper;
(f) blood pressure and pulse tests,
(g) visual examination, at the age of 13 years, colour evaluation,
(h) hearing, speech and voice examination;
(i) examination of the oral cavity, dental status and, where appropriate, recommendations for dental examination;
(j) evaluation of psychosocial development and motor skills in children aged 13 years; lessons related to health risks and consequences related to sexual life, including lessons learned about protected sex, questions about the menstrual cycle for girls,
(k) an assessment of the risks to further life arising from family and personal history, at 13 years of age, or a statement on the planned study;
(l) at 13 years of age, lipidogram, if there is a family history of ischaemic heart disease, myocardial infarction, angina pectoris, stroke or hyperlipoproteinaemia.
(2) The content of general preventive examinations for children aged 15 years is:
(a) the general examination and updating of the anamnestic data referred to in paragraph 1 (a), the control of the vaccination of the child, and, where appropriate, the addition of the missing vaccination to the extent provided for by the legislation governing vaccination against infectious diseases (1), the instruction on the possibility of further vaccination recommended for age, including both covered and not covered by public health insurance (2);
(b) the identification of the weight and height of the child, the identification of the body weight index and the assessment of the growth of the child on the basis of growth charts in order to detect possible malnutrition, overweight or obesity;
(c) complete physical examination, including skin examination and secondary sexual characteristics;
(d) urine examination using diagnostic paper;
(e) blood pressure and pulse tests,
(f) visual examination;
(g) examination of hearing, speech and voice,
(h) oral examination, dental status and, where appropriate, dental examination recommendations;
(i) an overall assessment of the condition and development of the child, lessons related to health risks and consequences related to sexual life, including lessons on protected sex, in girls recommendations for gynecological examination in the event of menstrual cycle disorders;
(j) an assessment of the risks to further life arising from family and personal history and an opinion on the employment and, where appropriate, study course related to the termination of compulsory education; for persons with disabilities, a statement on the limitation of preparation for work and capacity for work in connection with leaving compulsory education.
(3) The content of general preventive examinations for children aged 17 years is:
(a) supplementing the social, family and personal history referred to in paragraph 1 (a), checking the vaccination of the child and, where appropriate, adding the missing vaccination to the extent provided for by the legislation governing vaccination against infectious diseases (1), instructing the possibility of further vaccination recommended for the age, including both covered and not covered by public health insurance (2);
(b) the identification of the weight and height of the child, the identification of the body weight index and the assessment of the growth of the child on the basis of growth charts in order to detect possible malnutrition, overweight or obesity;
(c) complete physical examination, including skin inspection;
(d) urine examination using diagnostic paper;
(e) blood pressure and pulse tests,
(f) visual examination;
(g) examination of hearing, speech and voice,
(h) oral and dental examination, including advice on dental examination;
(i) guidance on protected sex, in girls according to a history of gynaecological examination,
(j) an assessment of the risks to further life arising from family history and personal history and comments on work and, where appropriate, study orientation; for persons with disabilities, a statement on limiting preparation for work and capacity to work.
(4) The last general preventive examination of children shall be carried out before completion of care with the provider in the field of practical medicine for children and adolescents, no later than the date of completion of 19 years of age. The content of the last general preventive examination of children shall include the actions referred to in paragraph 3 and a final assessment of the state of health before the completion of the care.
Contents and time ranges of dental preventive examinations
(1) The content of dental preventive examinations, which are carried out once a year in children between the sixth and twelfth months and twice a year in children and adolescents from 1 year of life to 18 years of age, usually after 5 months after the last dental preventive examination, is:
(a) the establishment of medical documentation when receiving care;
(b) a history with particular regard to the development of the orophatic system at the age of 3, 6, 12 and 15;
(c) an examination of the state of teeth, periodontal, mucosal and soft tissues of the oral cavity, anomalies in the position of teeth and jaws,
d) prevention of oncology aimed at searching for pre-tumor changes and tumour manifestations on the teeth, periodontal, jaws and soft tissues of the face and neck,
(e) a lesson on the importance of the prevention of dental diseases, the maintenance of proper oral hygiene, good eating habits, the importance of fluoride prevention in relation to the risk of dental decay and the risk of the transmission of cariogenic micro-organisms.
(2) The content of dental preventive examinations in adults which are carried out once a year, as a general rule 11 months after the last dental preventive examination, is:
(a) an examination of the dental, periodontal, mucosal and soft tissues of the oral cavity;
b) prevention of oncology aimed at searching for pre-tumor changes and tumour manifestations on the teeth, paradonna, jaws and soft tissues of the face and neck,
(c) guidance on correct oral hygiene.
(3) The content of dental preventive examinations in pregnant women performed twice during pregnancy is
(a) an examination of the dental, periodontal, mucosal and soft tissues of the oral cavity;
b) prevention of oncology aimed at searching for pre-tumor changes and tumour manifestations on the teeth, periodontal, jaws and soft tissues of the face and neck,
(c) a lesson on the importance of preventing dental disorders during pregnancy in both the woman and the future child, including on the proper hygiene of their oral cavity, on fluoride prevention and the need for dental rehabilitation before birth to prevent the transmission of cariogenic microorganisms from the oral cavity to the oral cavity;
(d) the lessons of the future mother on the need to provide dental preventive examinations of her child, the first between the sixth and twelfth months of her age.
Contents and time ranges of gynaecological preventive examinations
The contents of the gynecological preventive examination, which is carried out at 15 years of age and subsequently once a year, generally after 11 months after the last gynecological preventive examination, are:
(a) the establishment of medical documentation when receiving care;
(b) family, personal and occupational history and updating of this history taking into account known risk factors;
(c) clinical examination of breasts from 25 years of age in a positive family history of hereditary or familial occurrence of breast cancer or in the presence of other risk factors;
(d) skin examination and palpation examination of lymph nodes in the sexual organs;
(e) mirror examination and collaborative examination; is not performed in female virgo,
(f) the collection of material from the cervix for a cytological, possibly bacteriological or virological examination; is not performed in female virgo,
(g) pallet bimanual examination; in the absence of a clear result of the addition of the vaginal ultrasound probe examination,
(h) a lesson on the importance of preventive anti-cancer surveillance;
(i) self-examination exercises at the first inspection with the registering provider;
(j) a check on the completion of breast cancer screening, if this has not been carried out within the prescribed time limits, a recommendation to the patient to complete it and to inform the patient of the risks associated with its rejection or failure to pass it;
(k) the examination of the completion of a colorectal cancer screening examination, if this has not been carried out within the prescribed time limits, the recommendation of the patient to complete it and to instruct the patient about the risks associated with its rejection or failure to pass it.
Repeal
Decree No. 3 / 2010 Coll., establishing the content and time range of preventive inspections, is deleted.
Efficacy
This Decree shall take effect on 1 April 2012.
Minister:
Doc. MUDr. Heger, CSc., v. r.
1) Act No. 258 / 2000 Coll., on the Protection of Public Health and on the amendment of certain related laws, as amended. Decree No. 537 / 2006 Coll., on vaccination against infectious diseases, as amended.
2) Article 30 of Act No. 48 / 1997 Coll., on Public Health Insurance and on the amendment and addition of certain related laws, as amended.
Sign in for notes, favorites and notifications
Regulation Information
| Citation | Decree No. 70 / 2012 Coll., on preventive inspections |
|---|---|
| Regulation Type | - |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 07.03.2012 |
|---|---|
| Effective from | 01.04.2012 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
Comments 0