One in 10 Canadians admitted to hospital during the 2024-2025 fiscal year waited more than 48 hours in an emergency department, a 12-hour increase from the 2018-2019 period, according to a report from the Canadian Institute for Health Information (CIHI). The data indicates that systemic gaps, including an aging population and a shortage of long-term care, have turned emergency rooms into long-term holding areas for patients requiring complex care.
The human impact of this backlog is evident in cases like that of an 81-year-old Windsor, Ont., woman. After suffering a fall on Monday, she remained in a hospital hallway for more than 48 hours waiting for an inpatient bed. Her daughter, Maureen Armstrong, described the setting as a noisy, volatile environment that is unsuitable for long-term recovery.
Did You Know?
The proportion of patients requiring immediate or urgent medical care has surged significantly. According to the CIHI report, approximately two-thirds of emergency room patients now fall into these high-priority categories, representing 1.7 million more urgent cases than were recorded in the 2018-2019 fiscal year.
Why are emergency wait times increasing?
The backlog is driven by a combination of limited emergency room capacity and a lack of access to standard care, according to the CIHI. Nearly one in five Canadian adults currently lacks a regular health-care provider, causing patients to delay seeking treatment until their conditions become more severe. Dr. Michael Herman, an Ottawa-area emergency physician, notes that this results in a more complex patient population requiring more diagnostic testing and longer stays.
The strain is compounded by a shortage of long-term care options. The Ontario Long Term Care Association reports that nearly 50,000 people are currently on waitlists for such facilities in Ontario, nearly double the figure from a decade ago. Because other segments of the health-care system can reach capacity and “close the shutters,” Dr. Herman explains that the emergency department serves as the final, mandatory resort for patients with nowhere else to go.
What are the health consequences for patients?
Extended stays in emergency departments are associated with direct patient harm. A 2023 study published in JAMA Internal Medicine found that patients over age 75 who waited overnight in an emergency room faced a higher likelihood of in-hospital death compared to those moved to a ward before midnight. Cheryl Chui, director of health system analytics at CIHI, reported that approximately 16,000 patients died while waiting for care during the 2024-2025 fiscal year.
Expert Insight:
The current crisis represents a failure of systemic policy rather than a failure of emergency medicine itself. Because emergency departments are designed for brief, episodic interventions, they are fundamentally ill-equipped to provide the longitudinal care required by an aging population with multiple co-morbidities. Unless policy shifts to bolster primary care and long-term facility capacity, the “square peg in a round hole” dynamic described by Dr. Herman is likely to continue causing preventable adverse outcomes.
What may happen next for the health-care system?
The system faces continued pressure as the population ages and the demand for specialized care grows. While the number of acute care beds per capita has declined, the CIHI report suggests that increasing the availability of primary care physicians, specialist services, and long-term care beds could alleviate the current backlog. Future outcomes may depend on how quickly provinces implement recommendations from critical incident reviews, such as those conducted in Manitoba following care-related deaths. Without these systemic adjustments, experts anticipate that emergency departments will remain under extreme pressure, potentially leading to more patients leaving without being seen or experiencing significant delays in life-saving treatment.
Frequently Asked Questions
How much have wait times increased for hospital admissions?
In the 2024-2025 fiscal year, one in 10 patients spent more than 48 hours in the emergency department, an increase from the 36-hour average recorded in 2018-2019.
Are emergency rooms being flooded by patients with minor issues?
No. The CIHI report indicates that about two-thirds of emergency room patients require immediate or urgent medical care, contradicting the misconception that less severe cases are driving the backlog.
What is the primary cause of the emergency department backlog?
The backlog is attributed to limited emergency capacity, a lack of access to regular health-care providers, and a shortage of long-term care facilities to support an aging population, which forces patients into emergency departments as a last resort.
Do you believe that prioritizing long-term care funding would effectively reduce the current burden on emergency departments?
