Nearly one in 10 Canadians who were admitted to hospitals from the emergency department during the 2024-2025 fiscal year spent more than 48 hours waiting on a stretcher or in a chair before being assigned a bed, a new study suggests.
The report from the Canadian Institute for Health Information (CIHI) also found that, out of 16.1 million ER visits last year, roughly 1.5 million patients spent more than 14 hours in the emergency department.
“There’s a national crisis around emergency services because we’ve optimized everything,” Paul Parks, a past president of the Alberta Medical Association and ER physician, said in the report. “We’ve taken all the elasticity out of the system, but the tap is still flowing. There’s a crisis: insufficient connected community resources, and little continuing care and long-term care.”
The findings indicate that many emergency departments throughout Canada suffer from overcrowding, shortages in staffing, and insufficient bed and stretcher capacity, all of which have made it harder to meet rising demand.
Those shortages, paired with high levels of serious emergencies, can leave some patients waiting for long periods of time, the report said.
Acuity is the primary driver of the wait time for an initial physician assessment, meaning patients with the most serious medical needs are seen first. That can leave the elderly and patients with chronic illnesses like diabetes or hypertension with long waits in the emergency department, the report said.
“Longer waits for physician assessment are associated with potential risks, including worsening clinical condition, reduced timeliness of care and a greater likelihood of adverse events,” the report said.
Emergency departments at teaching hospitals and large urban hospitals accounted for most visits and saw higher volumes of more complex patients in 2024-2025, the study’s authors found.
Daily visit volumes were at their highest in these facilities. There were roughly 170 visits a day in teaching hospitals and 175 visits in large community hospitals during that timespan. Seventy-three percent of these patients had life-threatening or potentially life-threatening conditions, or were stable but still required urgent care.
Urban and teaching hospitals also have much higher admission rates than rural, small, or medium hospitals.
Age a Factor
Older patients tended to wait longer in the emergency department for an inpatient bed than young patients. The study found that people aged 85 or older waited an average of 8.3 hours while patients in the 75 to 84 age group waited 6.8 hours. Patients in the 18 to 34 demographic waited just three hours.
Once admitted, elderly patients often remain hospitalized for extended periods due to a lack of suitable discharge options.
A national average of 8 percent of patients admitted to hospital became “alternate level of care.” This status means they no longer required acute care but could not be discharged because appropriate follow-up care was not prepared for them. These patients often waited an average of 24 days in hospital inpatient units for transfer to a nursing home or for home care.
CIHI’s director of health system analytics, Cheryl Chui, said the report shows that improving emergency department wait times will require solutions that address the entire health-care system.
That includes ensuring everyone has access to a primary care provider to reduce reliance on emergency departments for non-urgent matters, while also expanding long-term care and home care services to enable patients needing alternative care to be discharged from the hospital more swiftly, she said in a media statement.
“You can see that sort of bottleneck creates a ripple effect through the system… which limits the capacity of emergency departments to be able to care for new patients who are coming in,” Chui said. “Then you see longer wait times across the board.”
The Canadian Association of Emergency Physicians issued a statement last week about the “severe strain” emergency departments (EDs) face due to “system-wide failures — particularly for older adults.” The association said more needs to be done to provide the care this demographic needs to free up much-needed hospital beds.
“Insufficiencies in long-term care and community capacity directly drive hospital and ED overcrowding,” the statement said. “When older adults cannot access these services, they remain in hospital beds after their acute medical issues are resolved.”
The Canadian Press contributed to this report.
