Unscheduled admissions within 84 hours of an outpatient visit: a measure of ambulatory care quality?

The occurrence screen, unscheduled medical or surgical admission within 84 hours of an outpatient visit, was found not to be useful in assessing quality of care or in suggesting actions to improve quality. A main finding of this study was the rather high percentage (69%) of episodes in which the reason for unscheduled admission was an exacerbation of a problem that could not be anticipated at the time of the outpatient visit. The quality of care at most institutions is likely to be high enough that alternative approaches to assessing and improving quality are recommended.