Analysis of dismissal rates for health reasons of the military personnel of the National Guard troops of the Russian Federation in 2017–2023

Ensuring combat readiness and personnel stability of law enforcement agencies is impossible without a deep understanding of the factors leading to premature dismissal of military personnel due to health reasons. Objective . To determine the structure of diseases that served as the basis for dismissal due to health reasons among contract military personnel in the National Guard troops. Materials and methods . The study included a retrospective analysis of reports from the military medical commission of the Federal State Budgetary Institution ‘Main Military Clinical Hospital of the National Guard of the Russian Federation’ for 2017–2023. Polymorbidity was assessed using the cumulative CIRS scale: the polymorbidity index (CIRS) and the severity of polymorbid pathology (CIRS-SI) were calculated. K-means clustering was used to identify typical combinations of diseases. Results . For the period 2017–2023, the average annual rate of military personnel discharged due to health reasons was 442 cases per 1,000 referred for military medical examination to determine their fitness for military service. After moderate stability in 2017–2019, a decrease in the number of examinations was observed in 2020, followed by steady growth, which was particularly pronounced in 2022–2023. The main reasons for dismissals are related to diseases of the circulatory system, neoplasms, diseases of the endocrine, musculoskeletal and nervous systems, mental disorders and injuries. A cluster analysis of polymorbidity was conducted, and five typical patterns of disease combinations were identified. The most pronounced CIRS and CIRS-SI index values were recorded in military personnel with hypertension, diabetes mellitus, and oncological diseases. Statistically significant age differences were established: military personnel in older age groups were more likely to have a greater number of concomitant diseases, while younger patients demonstrated a higher severity of pathology. Conclusion . The data obtained indicate a high level of polymorbidity among military personnel discharged due to health reasons. The identified patterns of combined pathology emphasise the need for systematic medical monitoring and the development of targeted preventive measures aimed at maintaining the working capacity and extending the service life of military personnel.