Association Between Physician Experience, Readmission for Heart Failure, and Risk of Mortality in a Super-Aged Society.

Background: The increasing prevalence of heart failure (HF) in aging populations challenges healthcare systems, especially in rural and insular regions of super-aged societies. This study examines hospitalization incidence rates (IRs) and the association between physician experience and HF prognosis in an insular super-aged cohort. Methods and Results: We conducted a retrospective population-based observational study including patients first hospitalized for HF between 2015 and 2019. Among 218 patients, 30 in-hospital deaths were excluded and 188 patients were followed up. We estimated hospitalization and readmission IRs and analyzed the association between physician experience and HF prognosis. Additionally, we conducted a landmark analysis 90 days post-discharge for readmissions. The first hospitalization IR for HF was 135/100,000 person-years (112 men, 157 women), and both rates increased with age. The median age was 86 years; 33% were ≥90 years, and 58% were female. Landmark analysis showed that 90-day all-cause mortality was significantly higher in patients with readmission than in those without (P=0.02). The multivariate Cox model confirmed a significant association between 90-day readmissions and all-cause mortality. The physician experience was not significantly associated with HF prognosis. Conclusions: This study highlighted the hospitalization IR for HF in a super-aged society and the high risk of all-cause mortality associated with 90-day readmissions. No significant association was identified between physician experience and HF prognosis.