The rates of hospital admissions and return visits to a rapidly growing pediatric emergency department as measures of quality of care

BACKGROUND: Return visits to the emergency department are viewed as a quality measure of patient management. Avoiding unnecessary admissions to the ward can potentially cause an increase in return visits, thus effecting quality assessment. METHODS: After implementing an educational process the relationship between admissions and return visits was assessed over time at a rapidly growing pediatric emergency department. RESULTS: There was a 264% increase in visits from 2004 to 2017. In the study period admission rates declined from 25 to 14%. This was achieved without a rise in return visits and with a stable percentage of admissions from return visits. CONCLUSIONS: Interventions aimed at decreasing unnecessary admissions do not lead to increased return visits and return visit admissions.