A damning new snapshot of Canada’s healthcare system reveals that emergency departments from coast to coast are struggling to keep up with growing patient demand and the people paying the price are often the country’s most vulnerable.
According to data released Thursday by the Canadian Institute for Health Information (CIHI), roughly 180,000 patients or about one in ten people admitted to an emergency department in 2024–25 waited more than 48 hours just to secure an inpatient bed. That’s not a wait to be seen. That’s a wait to simply move off a stretcher in a hallway and into a proper hospital room.
The numbers don’t stop there. Approximately 1.5 million Canadians spent more than 14 hours in emergency rooms over the same period a staggering 28 per cent jump compared to 2018–19, before the pandemic reshaped healthcare as we know it.
With 16.1 million emergency department visits recorded in 2024–25, and 12 per cent of those resulting in hospital admission, Canada’s ERs are functioning less like emergency rooms and more like overflow wards for an overburdened system.
CIHI Director of Health System Analytics Cheryl Chui was direct about where the problem begins and it isn’t inside the emergency department itself.
“We’re seeing patients with more complex needs arriving in the emergency department, as well as challenges moving patients through hospitals and into the next level of care when they’re ready to be discharged,” she said. “Together, these pressures are contributing to longer wait times.”
In other words, the emergency department is where the cracks in the broader system become impossible to ignore.
If there’s one thread running through the CIHI findings, it’s age. Older adults and patients with chronic conditions like diabetes or high blood pressure consistently rank among those waiting the longest in emergency rooms. The report confirms that admission rates climbed with age and that older patients faced longer waits for beds once admitted.
Part of the reason, the report explains, comes down to placement complexity. Younger patients can often be moved to the next available bed. Older patients with multiple conditions, isolation requirements, or specialized care needs must wait for the right bed on the right unit in a system that may not have one ready.
Dr. Michael Howlett, physician and former president of the Canadian Association of Emergency Physicians, says this is the defining healthcare challenge of the coming decades.
“Our population is aging. We’re seeing many more people with multiple health conditions, significant complicated health problems, and they take a lot more time, a lot of work, a lot of hospital care, and then that much more care when we try to get them back into the community,” he said. “There needs to be much more emphasis on how we as a society are going to take care of our elderly frail.”
Compounding the issue is what happens once older patients are well enough to leave the hospital. According to the report, patients awaiting transfer to long-term care homes, home care, or rehabilitation centres spent an average of 24 days in hospital inpatient units occupying beds that could otherwise serve incoming emergency patients.
The strain is felt most acutely in rural and remote communities. Ongoing staffing shortages have forced temporary closures of some emergency department sites, leaving patients in those areas with fewer options and longer distances to travel. The CIHI data found that one in four hospitalizations among rural residents involved what researchers classified as a high or very high travel burden a figure that worsens the more specialized the care required.
Dr. Howlett sees little relief on the horizon.
“The number of positions available for specialist-trained emergency physicians is not increasing. So some provinces have very few. Human resources become an issue,” he said, noting that the pipeline of trained emergency specialists simply hasn’t grown to match demand.
The message from experts is clear: solving Canada’s emergency room crisis won’t happen by tweaking a few workflows inside hospital walls. It will require a coordinated rethink of how the entire healthcare system is structured from primary care and prevention to home care, long-term care, and everything in between.
“Tackling emergency department wait times is really a health system issue that extends beyond the emergency department and the hospital,” Chui said. “We see the symptoms of the pressures across the health system manifesting in longer emergency department wait times. Improvements will require system-wide coordinated action across multiple sectors.”
For the 180,000 Canadians who spent two full days on a stretcher last year waiting for a bed, that system-wide action can’t come soon enough.
