A recent report from the Canadian Institute for Health Information (CIHI) highlights a significant increase in wait times in Canadian emergency departments (EDs), with one in ten patients spending more than 14 hours waiting for care during 2024-25. Based on data from the National Ambulatory Care Reporting System (NACRS), the report shows a 28 percent rise in prolonged waits compared to 2018-19, reflecting growing pressures across the healthcare system.
Approximately 1.5 million patients experienced these extended wait times in EDs across the country. Of the emergency visits recorded, about 12 percent resulted in hospital admission, and notably, one in ten admitted patients spent more than two days in the emergency department—a 33 percent increase since 2018-19. The report indicates that this trend is driven by an aging and medically complex patient population, particularly older adults who often require specialized care or appropriate inpatient beds.
Dr. Michael Herman, an emergency physician based in Ottawa, described the findings as reflective of the real challenges faced daily by healthcare providers. He emphasized that the data demonstrate not only an older, sicker population requiring care but also limited access to primary and long-term community supports, which contributes to overcrowding in EDs. “This isn’t just an inconvenience, this is lethal,” Dr. Herman stated, citing research from the United Kingdom linking extended ED wait times to increased mortality among elderly patients.
The CIHI report also revealed that 7.7 percent of patients left EDs before seeing a physician in 2024-25, while 0.1 percent died in the emergency department. Nearly two-thirds of visits were classified as high-acuity, indicating life-threatening or urgent conditions. Demographically, children under 10, adults over 55, and individuals from low-income neighborhoods accounted for the highest visit rates. Larger urban and teaching hospitals faced the greatest volumes and complexity of cases.
Another critical issue highlighted is the presence of alternative level of care (ALC) patients—those who no longer need acute hospital care but remain hospitalized due to delays in transfer to appropriate care settings. These patients had a median hospital stay of 24 days, far exceeding the four-day median for other admitted patients, thereby limiting bed availability for incoming ED admissions.
Healthcare professionals and advocates across the country have warned for years about the impact of ED overcrowding, which is exacerbated by hospital underfunding, staffing shortages, and seasonal challenges such as rural ED closures during summer months. Earlier this year, calls for a formal emergency declaration were made in Alberta following the death of Prashant Sreekumar, who died after an eight-hour wait in an Edmonton emergency department.
Cheryl Chui, CIHI’s director of health system analytics, stressed that addressing ED wait times requires a comprehensive approach targeting the entire healthcare system rather than focusing solely on emergency departments. The report underscores interconnected challenges including hospital bed shortages, limited primary and long-term care resources, and an increasingly complex patient population, all contributing to the growing strain on EDs nationwide.