New CIHI report finds people crowding ERs because there’s nowhere to discharge them

A new report says wait times at emergency departments across the country are made longer by lack of available spots in long-term care facilities and home care programs.The Canadian Institute for Health Information says patients who could be discharged to rehab centres, long-term care homes or home care end up waiting an average of 24 days in hospital inpatient units.That means other patients who need to be admitted to the hospital are stuck waiting in the emergency department for a bed to become available. From April 2024 to March 2025, half of admitted patients waited in the ER for more than 16 hours.One in 10 admitted patients spent more than 48 hours in the ER. The report says older adults and people with chronic conditions—such as diabetes or high blood pressure—are often in the emergency department the longest. Eight per cent of patients admitted to hospital became “alternate level of care,” meaning they no longer required acute care but couldn’t be discharged because there was no appropriate followup care ready for them. Cheryl Chui, the institute’s director of health system analytics, said the report’s findings show that improving emergency department wait times will require solutions that look at the entire healthcare system.That ranges from making sure everyone has access to a primary care provider so people don’t have to rely on emergency departments for non-urgent issues, to increasing long-term care and home care services so alternate level of care patients can be discharged from the hospital more quickly. “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.”The institute released its report on Thursday. Earlier in the week, the Canadian Association of Emergency Physicians issued a statement sounding the alarm on the “severe strain” emergency departments are under because of “system-wide failures—particularly for older adults.”“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, who currently make up 20 to 40 per cent of ED visits in Canada,” 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.”

New CIHI report finds people crowding ERs because there’s nowhere to discharge them

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