Background: Readmissions after hospitalisation are a healthcare quality indicator and carry considerable financial penalties in some healthcare systems. Internationally, readmission rates at 28 – 30 days for medical inpatients range between 10 – 22%. However there is almost no information available around readmissions for medical inpatients in the Middle East region. We conducted a pilot study to determine the rate of unplanned readmissions, to examine factors that influence readmission and identify potentially preventable readmissions within 28 days of discharge from our Acute Medical Assessment Unit (AMAU) in Qatar.Methods: The AMAU at our 603 bed tertiary academic medical centre is a 40-bed unit for medical inpatients expected to be hospitalised less than 3 days. It is staffed 7 days a week by a multi-disciplinary team that includes hospitalists and allied health professionals. All patients admitted to the AMAU between May and October 2016 were identified from the hospital electronic health record (Cerner). Records of patients who had at least one unplanned readmission within 28 days of discharge were audited retrospectively by a senior physician reviewer.

Results: 1670 patients were admitted during 6 months. 121 patients had a readmission within 28 days of discharge. The readmission rate was 7.2% at 28 days. 50% of these cases were readmitted within 7 days. Median age of readmitted patients was 53 years (range 14 to 90 years). 50% were male. Nationalities are shown in Figure 1. Diagnoses at the time of initial admission are shown in Figure 2. 52% percent were readmitted with the same diagnosis as initial admission. 71% of patients had 2 or more comorbidities, 21% had 3 or more comorbidities. Median length of stay of index admission was 7 days (range 1 to 24 days).

Conclusions:  Preliminary results suggest that 28 day readmission rates of medical inpatients in Qatar may be similar to or less than those of other regions. While many readmissions may not be preventable; targeting patients at high risk may decrease unnecessary readmissions. For example identifying patients who have specific diagnoses like GI, CNS or respiratory conditions, more comorbidities and longer length of stay during initial admission for appropriate post discharge follow-up may help decrease readmissions. We will further study factors related to preventable readmissions and develop interventions to address them.