Hundreds of thousands of sick and injured Canadians are spending up to two days or longer parked on hard stretchers or plastic chairs in the country’s swamped emergency departments, waiting for a scarce bed to open upstairs, and these delays can be deadly.
New data show that, in 2024-2025, one in 10 emergency patients — 1.5 million people — spent more than 14 hours in emergency.
Of the 16.1 million ER visits reported in total, 1.8 million people needed to be admitted to hospital.
While half waited less than five hours for a bed after the decision was made to admit them, one in 10, or 180,000 people, languished 48 hours or more in emergency before they were moved to a ward bed or the operating room.
Studies have shown that for every 82 people waiting more than six to eight hours to be transferred to a bed, one additional death will occur, meaning that “for those 180,000 patients waiting more than two days for an inpatient bed, we could expect 2,195 attributable deaths,” said Ottawa emergency physician Dr. Michael Herman.
“This is not just inconvenient for patients, this is lethal.”
The new report from the Canadian Institute for Health Information validates “what we’ve been saying on the frontline for years now,” said Herman, a director on the Canadian Association of Emergency Physicians’ board of directors.
People are landing in emergency sicker, many with multiple underlying health problems in addition to whatever brought them to hospital, and staying longer.
Two-thirds are being triaged as “high acuity,” meaning with conditions that are either life-threatening, such as cardiac arrest, or require rapid medical attention (severe chest pains, signs of sepsis, severely abnormal vital signs) — shooting down the “zombie myth that refuses to die” that waits times are being driven up by people with minor complaints, Herman said.
“The data clearly show that’s not true. We’re seeing a decrease in our low acuity patients and yet wait times are still going up.”
According to CIHI, severe, unstable cases have increased from 59 to 66 per cent of all emergency visits, or 1.7 million more visits since the pre-COVID year of 2018-2019.
Across Canada, ER wait times are intensifying in overcrowded, short-staffed hospitals big and small, urban and rural. Stretchers and beds aren’t keeping pace with growing demand, creating backlogs and growing wait times and more frustrated people are leaving before being seen by a doctor.
In 2024-25, 7.7 per cent of emergency visits — 1.2 million — involved someone leaving without being assessed by a doctor, according to the report.
Pre-pandemic, it was 5.4 per cent, or roughly 800,000 visits.
People aged 55 and older face the longest waits for a hospital bed. Unlike younger people, they can’t simply be moved into the first available bed. They often need to be in a specialized unit or isolation bed for infections like pneumonia.
Emergency departments are witnessing historic levels of boarding, a risky and humiliating practice of holding admitted patients on stretchers in loud, crowded, chaotic hallways or any available makeshift space.
The longer people, especially older people, stay in emerge when they’re admitted, the worse their outcomes, Herman said. ERs are set up for “brief, episodic care and high turnover,” he said. They aren’t resourced to provide the level of care the way an inpatient ward is, increasing the risk of deterioration and delirium.
The report highlights that the emergency crisis is largely outside emergency’s control. It’s a decades-old, inflow-outflow problem.
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