Canada’s Emergency Departments Under Strain: One in 10 Patients Wait Over 48 Hours for a Bed
Canada’s emergency departments are under mounting pressure, with one in 10 patients—about 180,000 people—waiting more than 48 hours in emergency rooms before being admitted to an inpatient bed in 2024–25, according to new data from the Canadian Institute for Health Information (CIHI).
The report highlights that around 1.5 million people spent more than 14 hours in emergency departments during the same period, marking a 28% increase compared with 2018–19. CIHI attributes these trends to overcrowding, staffing shortages, and limited bed and stretcher capacity that have struggled to keep pace with rising demand.
Who Is Most Affected?
Older adults and patients with chronic conditions such as diabetes or high blood pressure tend to spend the longest time in emergency departments. CIHI notes that wait times for inpatient beds increase with age, and older patients with multiple health issues or special care requirements often wait longer for an appropriate bed, such as an isolation bed or a specialist ward bed.
“Longer waiting times for medical assessment are associated with potential risks, including worsening of clinical status, reduced timeliness of treatment and a greater likelihood of adverse events,” the report states.
System-Wide Pressures Behind Emergency Wait Times
Cheryl Chui, director of health systems analysis at CIHI, emphasized that the root causes of long emergency department waits lie largely outside the emergency room itself.
“We are seeing patients arrive at the emergency department with more complex needs, and we are also seeing difficulty moving patients through hospitals to the next level of care when they are ready for discharge,” Chui said.
Patients awaiting discharge to long-term care homes, home care, or rehabilitation centers wait an average of 24 days in hospital inpatient departments. The report suggests this reflects both limited availability and mismatched bed types, particularly for older patients with comorbidities or infection-control needs.
Aging Population and Complex Care Needs
Dr. Michael Howlett, a physician and former president of the Canadian Association of Emergency Physicians, said the growing proportion of older patients with multiple health conditions is intensifying pressure on hospitals and community care systems.
“Our population is getting older. We’re seeing a lot more people with multiple health conditions, significant complex health issues, and they’re taking up a lot more time, a lot of work, a lot of hospital care, and then they take even more care as we try to reintegrate them into the community,” Howlett said.
He added that more emphasis is needed on how society cares for frail older people, including better support for transitions from hospital to community-based care.
Staffing Shortages and Rural Access Challenges
The report also points to ongoing staffing shortages that have led to temporary closures of some emergency department locations, particularly affecting rural and remote communities. One in four hospitalizations among people living in rural or remote areas involve a high or very high travel burden, which increases with the level of specialization required.
Howlett noted that the number of positions for specially trained emergency responders is not growing in line with demand, and in some provinces there are very few such roles, making human resources a critical constraint.
Chui stressed that addressing emergency department wait times is not solely a hospital issue. “We are seeing the symptoms of pressure across the healthcare system, manifested in longer emergency room wait times,” she said. “Our data suggests that improvements will require system-wide coordinated action across multiple sectors, including primary care, hospital, home and community care, and long-term care.”
