Half of patients admitted to Canadian emergency departments waited more than 16 hours for a hospital bed between April 2024 and March 2025. One in 10 waited more than 48 hours.
A new report from the Canadian Institute for Health Information (CIHI) says those numbers are directly tied to what happens upstream in the health-care system, specifically a shortage of spaces in long-term care homes, rehabilitation centres and home care programs.
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The bottleneck that backs up the ER
When patients are well enough to leave a hospital inpatient unit but have nowhere appropriate to go, they stay. According to CIHI, those patients wait an average of 24 days in hospital before they can be discharged. During that time, the beds they occupy are unavailable to patients coming in through the emergency department.
Eight per cent of patients admitted to hospital fell into what's called "alternate level of care" status during the reporting period, meaning they no longer needed acute medical treatment but couldn't leave because the right supports weren't in place.
Older adults and people managing chronic conditions like diabetes or high blood pressure were most likely to be among those waiting the longest in the ER.
Cheryl Chui, CIHI's director of health system analytics, said the findings point to problems that can't be solved by looking at emergency departments in isolation.
"You can see that sort of bottleneck creates a ripple effect through the system because the extended stays in acute care then delay patients from being able to be moved into those acute care beds, which then means they're staying in the emergency department ... 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."
Calls for system-wide solutions
CIHI says addressing ER wait times will require action at multiple points in the system, from expanding access to primary care providers so people aren't using emergency departments for non-urgent issues, to increasing long-term care and home care capacity so hospitals can discharge patients more quickly.
The report was released Thursday. Earlier this week, the Canadian Association of Emergency Physicians issued a separate statement describing the "severe strain" emergency departments are under due to what it called "system-wide failures, particularly for older adults."
The association said older Canadians now make up 20 to 40 per cent of all emergency department visits across the country.
"A widening gap between those in need of enhanced daily support as they age, including long-term care and community-based supports, and timely access to them has made the ED the only accessible option for many older Canadians," the statement said. "Insufficiencies in long-term care and community capacity directly drive hospital and ED overcrowding. When older adults cannot access these services, they remain in hospital beds after their acute medical issues are resolved."
*With files from CP
