Comorbidity of Internal Diseases as a Public Health Challenge

Comorbidity, that is, the simultaneous presence of two or more chronic diseases, has become a prevalent phenomenon in modern medicine, especially in relation to internal pathologies. The aim of this article was to justify the need for transition from fragmented care to a personalized, multidisciplinary, and digital model for comorbidity patients, as well as to propose a “Digital Integrated Clinical Platform” concept for primary healthcare adapted to Russian background. Materials and methods. The analysis included data about 18,740 patients aged 50 years and older with multimorbidity in Moscow, the Republic of North Ossetia-Alania, and the Chechen Republic for the period 2020-2024 obtained from the Unified State Health Information System (EGISZ), electronic medical records, and regional registries. Official reporting forms of the Ministry of Health, clinical data, and the results of international studies (Chronic Care Model, ESSE-RF, HAPIEE) were used. In this study, such methods as descriptive and comparative statistics, polypharmacy analysis (STOPP/ START criteria), regression analysis predicting hospitalization length and quality of life (EQ-5D-5L), as well as system and SWOT analysis of digital platforms and care models were used. Results. Analysis of data about 18,740 patients with comorbidity revealed a high polypharmacy burden (an average of 7.3 medications), particularly in regions with low digital engagement that lack specialized care. The data confirm the need to create a unified digital platform for standardized and secure management of multimorbid patients across the country.

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