Emergency Department Delays: A Growing Concern for Seniors

A startling new study reveals a significant increase in the proportion of older adults experiencing prolonged stays in emergency departments (ED) from 2017 to 2024. This trend, detailed in a recent research letter published in JAMA Internal Medicine, raises urgent questions about the efficiency of our healthcare system.

Data from Millions Highlights Troubling Trends

Researchers led by Dr. Adrian D. Haimovich from Beth Israel Deaconess Medical Center examined a staggering dataset from Epic Cosmos, which encompasses records for 295 million older adults and 78 million admissions during the period. Their goal? To investigate the alarming rise in prolonged emergency department length of stay (LOS) and increased boarding times.

Prolonged Stays on the Rise

The findings are eye-opening: in 2017, only 12% of emergency department encounters for seniors lasted longer than eight hours. Fast forward to 2024, and that number has skyrocketed to 20% for 12 million encounters. In academic hospitals, the situation is even worse, with prolonged stays jumping from 19% to a staggering 30%.

Boarding Times Soar Amidst Healthcare Chaos

But it's not just the length of stay that’s concerning. The study also revealed that boarding times—in which patients wait for a bed after a request—rose alarmingly. The percentage of boarding patients waiting more than three hours surged from 22% to 36%, with academic hospitals faring the worst, escalating from 31% to 45%.

Impact of the COVID-19 Pandemic

Initially, from 2017 to 2020, both measures experienced slight annual increases. However, the onset of the COVID-19 pandemic brought about a dramatic spike. Between 2020 and 2022, the average length of stay rose by 4.2%, while boarding times jumped by 6.1%. Although a partial recovery was seen between 2022 and 2024, with slight decreases, the overall trend is still deeply troubling.

A Call for Immediate Action

"Worsening emergency department LOS and boarding times contribute to crowding, signal systemic dysfunction in healthcare, and most importantly, jeopardize patient well-being," the authors caution. This situation calls for urgent reforms in the healthcare system to ensure that our seniors receive timely and effective medical care.