Trends in Emergency Department Stay Durations for Seniors from 2017 to 2024

Between 2017 and 2024, there was a significant rise in the percentage of older adults experiencing prolonged stays in emergency departments (ED) and extended boarding times. A recent study published in JAMA Internal Medicine analyzed health records from the Epic Cosmos database, encompassing over 295 million older adult encounters and 78 million hospital admissions across the United States. The findings revealed that in 2017, about 12% of ED visits for seniors resulted in an ED length of stay (LOS) exceeding eight hours. By 2024, this proportion had nearly doubled to 20%. The increase was most notable within academic hospitals, where prolonged ED stays jumped from 19% to 30%. Similarly, the share of patients waiting more than three hours for bed requests before admission rose from 22% to 36%, with academic hospitals experiencing a rise from 31% to 45%. The data indicated minor annual increases from 2017 to 2020, followed by a sharp surge during the COVID-19 pandemic between 2020 and 2022. A partial recovery was observed from 2022 to 2024, with decreases in both ED LOS and boarding times. The researchers highlighted that these worsening conditions contribute to overcrowding, systemic healthcare issues, and potential harm to patients. Overall, the study underscores the urgent need for healthcare reforms to improve emergency care efficiency for the aging population.