Prolonged Emergency Department Stays Among Seniors Rise from 2017 to 2024

A recent study has revealed a concerning trend regarding older adults' experiences in emergency departments (EDs) in the United States. According to findings published in JAMA Internal Medicine, the period from 2017 to 2024 witnessed a significant increase in the proportion of seniors facing extended lengths of stay (LOS) in emergency departments.

The research, led by a team from Beth Israel Deaconess Medical Center in Boston, analyzed data from the Epic Cosmos health records database, which encompasses a vast cohort of 295 million older adults and 78 million admissions. The aim was to evaluate the prevalence of prolonged emergency department visits and the associated boarding times.

In 2017, 12% of the 4,564,359 emergency department encounters examined had a length of stay exceeding eight hours. This figure escalated to 20% by 2024, highlighting a troubling trend in the care of older adults. In academic hospitals, the increase was even more pronounced, with prolonged LOS rising from 19% to 30% of encounters. Additionally, the percentage of patients experiencing delays in boarding, defined as the time taken from bed request to admission exceeding three hours, climbed from 22% to 36% during the same period.

The trend exhibited smaller annual increases in both LOS and boarding times from 2017 to 2020, with rates rising by 1.1% and 2.8% respectively. However, a sharp escalation was noted between 2020 and 2022, coinciding with the challenges posed by the COVID-19 pandemic, which saw LOS increase by 4.2% and boarding times by 6.1%. Following this peak, a modest recovery occurred from 2022 to 2024, with LOS decreasing by 1.7% and boarding times dropping by 3.2%.

The findings of this study raise important questions regarding the efficiency of emergency care for older patients. The authors emphasize that the worsening lengths of stay and boarding times in emergency departments contribute to overcrowding and reflect systemic issues within the healthcare system, ultimately impacting patient well-being.

Addressing these challenges is critical for improving the quality of care for older adults, particularly as the population continues to age. The research underscores the need for systemic changes within the healthcare infrastructure to ensure timely and effective emergency care for seniors.

For further insights, related studies include works by Maura Kennedy and colleagues, who discuss the broader implications of hospital boarding crises in the U.S. healthcare system.