You will receive referrals for these tests from a primary health care physician [LIST]. Lots of changes from July 1

From 1 July this year. changes in primary health care, commonly referred to as the primary health care reform, enter into force. From the patient’s perspective, one of the most important is the extension of the scope of diagnostic tests that can be performed under the National Health Fund. The list has grown by eight items. Below we present the “news” and explain which diseases can be detected by these tests.

1. From 1 July this year. the primary care physician may refer the patient to more tests than before
2. Among the tests that appeared on the list of reimbursed studies is the determination of the level of ferritin and vitamin B12
3. Some examinations may be performed by the family doctor on the spot. This includes CRP, which will allow you to check the inflammation in the child, and a test to detect streptococci responsible for angina
4. At health care, we will obtain a referral for a test of the level of antibodies that will allow us to diagnose rheumatoid arthritis and hepatitis C.
5. Another novelty is the assessment of the presence of Helicobacter pylori in the stool – the test order is issued by the general practitioner
6. More information can be found on the Onet homepage

Ferritin – diagnosis of iron deficiency

Ferritin is a protein that stores iron in the cells of the body. Its increased level may indicate the development of inflammation in the body or a chronic disease, while ferritin deficiency is closely related to too low iron concentration. The test is performed as part of the diagnosis of anemia, as well as suspected chronic inflammation of the body, cancer and haemochromatosis.

Ferritin is a single blood sample taken from a vein in the arm. You should come to the treatment room on an empty stomach. Some medications and dietary supplements may affect the test result, so it is worth consulting this issue with your doctor beforehand.

Vitamin B12 – anemia and more

Vitamin B12 plays a very important role in the body. She is responsible, inter alia, for regulating the production of red blood cells, supports the work of the nervous system and cell synthesis, reduces the level of lipids in the blood. Testing its level allows you to detect anemia, but the test is also ordered in patients after gastric resection, when diagnosing neurological disorders, in the case of suspected tapeworm infection, in people abusing alcohol, as well as prophylactically in vegetarians and vegans (this vitamin is mainly found in of animal origin, which are not present in the diets of these people).

Testing the level of vitamin B12 also involves taking blood, and the material being analyzed is serum. You should go to the diagnosis on an empty stomach.

Anti-CCP antibodies – rheumatoid arthritis

Antibodies to cyclic citrullinated peptides are proteins that are produced by the immune system in response to an amino acid called citrulline. Their level testing is an important diagnostic criterion in the case of suspected rheumatoid arthritis (RA). Although their elevated level does not occur in all RA patients, together with other rheumatic studies it facilitates the diagnosis of the disease and is valuable information for a specialist looking for the cause of ailments such as chronic pain in the joints.

You do not need to be on an empty stomach to test for anti-CCP antibodies. Performing the examination privately costs an average of PLN 60, so its reimbursement is a significant saving for patients.

Anti-HCV antibodies – hepatitis C

The anti-HCV antibody test detects the presence of antibodies in the body against one of the most common viruses that cause hepatitis (type C). A person who has had no contact with him and is healthy, the result should be negative, if infected, the result will be positive. Importantly, the test will not necessarily detect an actual infection. In the case of a positive result, RT-PCR testing is usually ordered to confirm or exclude the presence of the virus in the body.

The test is based on the analysis of a venous blood sample, and the test itself does not require special preparation on the part of the patient. You do not need to be fasting, and the test can be taken at any time of the day.

Test for the presence of Helicobacter pylori in the stool

Helicobacter pylori is a bacterium responsible i.a. for gastric or duodenal ulcers and inflammation of the mucosa of this organ, which, if left untreated, may lead to the development of neoplastic disease. Infection with it is common – it is estimated that more than half of the world’s population has had contact with the bacterium.

Testing for the presence of Helicobacter pylori in the feces is performed in order to detect bacterial anti-antigens present in this material. Such a test is characterized by high sensitivity (91%) and specificity (93%). To perform it, it is enough to collect a stool sample yourself and deliver it to the laboratory, analytical laboratory or treatment room / collection point in a sterile container. The urinary bladder must be voided prior to sampling.

Strep-test – streptococci and angina

Strep-test is an immunological test that allows to detect the presence of group A streptococcus in the body. It is a bacterium that is a common cause of acute inflammation of the throat and tonsils. It helps to confirm angina in a quick and non-invasive way.

Group A Streptococcus can be identified by throat swab (the sample is taken as in the COVID-19 test). It should be performed 48-72 hours. from the onset of symptoms, it is good if the patient abstains from eating a meal approx. two hours before the examination. The waiting time for the result is from a few to several minutes, so the test can be performed during a visit to the doctor.

The rest of the text below the video.

CRP in a child – inflammation in the body

CRP is a C-reactive protein, or acute phase protein, synthesized by the liver. If its levels are high, inflammation is likely to develop in your body. The assessment of the CRP level is also a support in the diagnosis of heart diseases. In the case of children, CRP examination allows to confirm or rule out microbial infection and to assess the severity of the infection, which affects the choice of treatment. The test does not indicate a specific type of pathogen, although often a slightly elevated CRP level indicates an infection with a viral origin, and a high CRP – a bacterial one (however, it is not a rule).

Blood for the determination of the CRP level in a child is drawn from a vein (in newborns and infants and older children) or a fingertip (children up to 4 years of age). The test should be performed on an empty stomach, if possible.

In addition, the family doctor will be able to refer the patient to a chest computed tomography scan, but only if the patient is after an X-ray, the result of which suggests changes that need to be verified with a more precise examination.

Other tests for which you may get a referral from your GP

The above research completed the long list of tests that may be commissioned by health care centers. They are among medical laboratory diagnostics, as well as imaging and non-imaging diagnostics tests: Below you will find a full list of them.

Hematological tests:

1. peripheral blood count with platelets,
2. peripheral blood count with percentage formula and platelets,
3. retikulocyty,
4. sedimentation rate of red blood cells (ESR).

Biochemical and immunochemical tests:

1. sodium,
2. potassium,
3. ionized calcium,
4. iron,
5. iron – total binding capacity (TIBC),
6. transferrin concentration,
7. glycosylated hemoglobin (HbA1c),
8. urea,
9. creatinine,
10. glucose,
11. glucose load test,
12. total protein,
13. proteinogram,
14. albumin,
15. C-reactive protein (CRP),
16. uric acid
17. total cholesterol
18. cholesterol-HDL,
19. cholesterol-LDL,
20. triglycerides (TG),
21. total bilirubin,
22. direct bilirubin,
23. alkaline phosphatase (ALP),
24. aspartic aminotransferase (AST),
25. alanine aminotransferase (ALT),
26. gammaglutamylotranspeptydaza (GGTP),
27. amylase,
28. creatine inhibitors (CK),
29. Total acid phosphatase (ACP),
30. rheumatoid factor (RF),
31. miano antystreptolizyn O (ASO),
32. hormon tyreotropowy (TSH),
33. antygen HBs-AgHBs,
34. VDRL,
35. FT3,
36. FT4,
37. PSA – complete prostate specific antigen.

Urine test:

1. general examination of urine with the assessment of physical and chemical properties as well as microscopic evaluation of the sediment,
2. quantitative protein determination,
3. quantitative glucose determination,
4. quantitative determination of calcium,
5. quantitative determination of amylase.

Stool tests:

1. examination,
2. parasites,
3. occult blood – by immunochemical method.

Coagulation tests:

1. prothrombin index (INR),
2. kaolin-kephalin time (APTT),
3. fibrynogen.

Microbiological testing:

1. urine culture with an antibiogram,
2. throat swab culture with antibiogram,
3. stool culture for Salmonella and Shigella.

Electrocardiogram (EKG) examination at rest

Ultrasound diagnostics:

1. Ultrasound of the thyroid and parathyroid glands,
2. Ultrasound of salivary glands,
3. Ultrasound of the kidneys, ureters, bladder,
4. Ultrasound of the abdomen and retroperitoneal space, including the initial assessment of the prostate gland,
5. Ultrasound of peripheral lymph nodes.

Spirometry.

Radiological photos:

1. chest image in AP and lateral projection,
2. bone photos – in the case of the spine,
3. limbs and pelvis in AP and lateral projection,
4. a photo of the skull,
5. photo of the bays,
6. abdominal overview photo.

Endoscopic examinations:

1. gastroscopy,
2. colonoscopy

Changes in POZ from July 2022.

In addition to inclusion in the list of reimbursed examinations, which may be ordered by a primary care physician, as part of the primary health care reform, also preventive programs will be changed, e.g. Prophylaxis 40 Plus. In the fall, a lottery will be held for people who benefited from the research. On the other hand, health care institutions, for high attendance in preventive programs (apart from the above, also programs for the prevention of cervical cancer and cardiovascular diseases) will receive bonuses.

Another change will be the increase of the group eligible for research (in the case of heart disease diagnostics) and the expansion of the competences of nurses who will be able to perform some of the services under the programs independently.

– The determinants of the primary health care reform (…) will be based primarily on increasing the scope of prevention in the population, changing the philosophy of paying for services, i.e. fees for specific medical services instead of lump sum payments, changing the way of managing chronically ill patients, there will be more diagnostics and coordinated care – he said during the press briefing, the Minister of Health, Adam Niedzielski.

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