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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.

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