​NSHU informs that it does not intend to limit the preventive package intended for insured persons over 40 years of age. CNAS’s clarifications come after GPs were asked to provide the House with a list of asymptomatic patients over 40 (who do not have chronic conditions) and there have been public fears from GPs that CNAS intends to limit the package of preventive services for these people .

“Regarding the address at which CNAS asked family doctors to clarify how many asymptomatic people over 40 are on their patient lists, the purpose of this centralization of information is to determine the amount of funding for the prevention package at the national level, according to the total number of care recipients and building an indicator for evaluating preventive activities, given that in the first half of this year, preventive consultations of all age categories accounted for only 1% of the total number of consultations of family doctors.” the National Health Fund reports.

Notification of NSZU:

• “Given the statements that appeared in the public space, according to which CNAS wants to limit the preventive package intended for insured persons over 40 years old, we make the following clarifications:

• As part of the package of services regulated by the social health insurance system at the level of primary medical care, preventive services are provided for all age groups. Among the preventive consultations offered by family doctors (which may also recommend a set of medical laboratory tests), there are also those intended for asymptomatic people over 40 years of age from their own lists, that is, those who are not on the family register. a doctor with chronic diseases and also shows no signs of illness.

• Precisely because these people consider themselves completely healthy, they rarely consult doctors, only in case of acute conditions, risking developing “hidden” chronic diseases (without symptoms), which are detected only at an advanced stage, in which complications, disabilities and even premature death, and the treatment will be difficult, painful and expensive or even ineffective.

• People over the age of 40 need special attention, as the incidence of chronic diseases increases significantly after this age.

• With the help of prevention packages, CNAS aims to encourage the above-mentioned persons to periodically check their health status, as well as family doctors to actively provide preventive consultations, during which it is possible to assess behaviors that have a global impact on health (lifestyle: smoking, problematic alcohol use, physical activity, diet, etc.), cardiovascular risk, cancer, mental health, reproductive health, and to intervene in modifiable risks.

• In the medium and long term, such an approach will lead to an increase in the quality of life of patients who are thus detected early and treated at an early stage of the disease, to a decrease in the costs associated with the disease, as well as to a decrease in the number of hospital medical services in favor of primary medicine (inversion pyramid of medical services).

• People with chronic diseases who are on the lists of family doctors benefit from periodic monthly consultations carried out by the FNUAS to monitor the progress of the disease, continuity of therapy, screening for complications, teaching care and self-care, etc.

• If the family doctor, after assessing the risk of developing other diseases, finds that the relevant patients have certain symptoms or test results outside the normal range, he can also provide advice on active monitoring (case management) for chronic diseases with a serious impact (hypertension, dyslipidemia and type 2 diabetes, bronchial asthma, chronic obstructive pulmonary disease – COPD, and chronic kidney disease).

• At the same time, in the case of exacerbation of chronic diseases or the presence of any symptoms, the origin of which must be clarified, patients appear to the family doctor, who, after an examination, determines the therapeutic course. For any acute/sub-acute condition/exacerbation of a chronic disease, the hospital insurance company bills the family doctors for two more consultations for each episode of the disease, in addition to the periodic consultations already mentioned.

• After the consultation, the family doctor can issue referral vouchers (including for paraclinical medical examinations) or other documents.

• Therefore, the family doctor provides comprehensive consultations, taking into account all acute, subacute and chronic diseases that patients suffer from, as well as researching risk factors for the occurrence of other diseases or exacerbation of existing ones, performing as primary prevention (prevents the occurrence of diseases by interfering with risk factors), secondary prevention ( early detection of the disease, before it manifests itself), tertiary prevention (screening for complications with a reduction in exacerbations or occurrence of complications).

• In summary, patients with chronic conditions do not need to use the Asymptomatic 40+ Prevention Pack because they are in constant contact with their GP and this pack was originally designed for people who have no signs/symptoms and who do not have regular health checks ‘I.

• Regarding the address where CNAS asked family doctors to clarify how many asymptomatic people over 40 years old are on their patient lists, the purpose of this centralization of information is to determine the amount of funding for the prevention package at the national level, according to the total number of beneficiaries and to build an indicator to assess preventive activities, taking into account that in the first half of this year, preventive consultations of all age categories accounted for only 1% of the total number of consultations of family doctors. “

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