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GMAC was one of several firms that sought an emergency conversion into a bank holding company last fall, which qualified it for a host of federal aid programs, including government guarantees of its debt.
Surgeons of low or even moderate OPCAB experience have been found to be predictive of emergency conversion [ 32] as well as responsible for poor graft patency and incomplete revascularization [ 33].
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Finally, a sub-analysis of a large randomized controlled trial concluded that the apparent benefits of off-pump CABG essentially disappeared when the morbidity and mortality of emergency intra-operative conversion to the on-pump procedure were taken into account [ 9, 10].
Higher conversion rates from emergency department attendance to admissions might be caused by risk adverse decision making in the emergency department or lack of access to alternative services to admission at the emergency department.
Systems with higher rates of potentially avoidable admissions had higher attendance rates at emergency departments, higher rates of conversion of emergency department attendances to admissions, higher proportions of very short stay patients, higher rates of ambulance calls transported to hospital and better perceived access to GP (table 2).
There were no significant differences between the two groups in conversion, detection or emergency presentation rates.
In the period under study, the overall conversion, detection and emergency presentation rates all changed significantly.
Further support comes from the trauma literature [ 8, 9, 14] where emergency cricothyroidotomies were maintained without conversion to a formal tracheostomy with low morbidity.
The emergency department attendance rate, the conversion rate of emergency department attendances into hospital admissions, and the proportion of admissions with a very short length of stay were higher in some systems than others and were associated with higher rates of potentially avoidable admissions.
There was a significant reduction in the variability of referral ratios and conversion, detection and emergency presentation rates, with a notably larger reduction in the interquartile range of referral ratios for 'activity' practices compared with those not taking up any specified activity (Table 3).
Against an overall 29% increase in 2-week referral rates between 2010 and 2013, there was a significantly greater increase for practices engaging in any of the four specified activities, but no significant differences in conversion, detection or emergency presentation rates (Table 2).
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