New Study Reveals Sharp Rise in Emergency Department Waits for Older Adults

Older Americans are experiencing significantly longer emergency department stays and boarding times than in previous years. It’s a trend that has worsened since the COVID-19 pandemic, according to a new research letter published in JAMA Internal Medicine titled “Prolonged Emergency Department Stays for Older US Adults.”

The study analyzed more than 12 million emergency department visits across 1,600 hospitals. It found that the percentage of older patients whose length of stay — the total time from arrival to departure from the emergency department — exceeded eight hours increased from 12% in 2017 to 20% in 2024. The rise was even more dramatic in academic hospitals, where the prolonged length of stay reached 30% in 2024.

In addition, the proportion of older patients admitted to the hospital who experienced prolonged boarding times, or a delay of more than three hours between a bed request and actual hospital admission, increased from 22% to 36% over the same period. Academic hospitals again faced the steepest challenges.

The Centers for Medicare & Medicaid Services, a federal agency that administers the nation’s major health care programs, recently introduced its Age-Friendly Hospital Measure to improve care for older adults across hospital settings, including emergency departments. As of January 2025, hospitals must demonstrate processes to limit emergency department length of stay to under eight hours and boarding times to under three hours.

“These findings highlight how emergency department overcrowding and boarding may harm the care of older adults, and underscores the urgency of implementing targeted policies to reduce emergency department length of stay and boarding, particularly as new federal reporting initiatives take effect,” said Sarah Berry, MD, MPH, senior scientist at the Hinda and Arthur Marcus Institute for Aging Research and division chief of gerontology at Beth Israel Deaconess Medical Center. “Addressing these delays is critical to safeguarding older patients and the health systems that serve them.”

The research also showed that after relatively small annual increases between 2017 and 2020, there was a sharp spike in delays during the COVID-19 pandemic, with only partial recovery through 2024. The study authors note that these patterns reflect systemic health care dysfunctions, including persistent staff shortages, bed availability constraints, and lack of post-acute care discharge options.

In addition to Dr. Berry, researchers included Adrian D. Haimovich, MD, PhD, assistant professor of emergency medicine at Beth Israel Deaconess Medical Center; and Bruce E. Landon, MD, MBA, MSc, professor of health care policy, Department of Health Care Policy, Harvard Medical School.

About Hebrew SeniorLife
Hebrew SeniorLife, an affiliate of Harvard Medical School, is a national senior services leader uniquely dedicated to rethinking, researching, and redefining the possibilities of aging. Hebrew SeniorLife cares for more than 4,500 seniors a day across campuses throughout Greater Boston. Locations include: Hebrew Rehabilitation Center-Boston and Hebrew Rehabilitation Center-NewBridge in Dedham; NewBridge on the Charles, Dedham; Orchard Cove, Canton; Simon C. Fireman Community, Randolph; Center Communities of Brookline, Brookline; Jack Satter House, Revere; and Leyland Community, Dorchester. Founded in 1903, Hebrew SeniorLife also conducts influential research into aging at the Hinda and Arthur Marcus Institute for Aging Research, which has a portfolio of more than $98 million, making it one of the largest gerontological research facilities in the U.S. in a clinical setting. It also trains more than 500 geriatric care providers each year. For more information about Hebrew SeniorLife, follow us on our blog, Facebook, Instagram, Threads, and LinkedIn.

About the Hinda and Arthur Marcus Institute for Aging Research
Scientists at the Marcus Institute seek to transform the human experience of aging by conducting research that will ensure a life of health, dignity, and productivity into advanced age. The Marcus Institute carries out rigorous studies that discover the mechanisms of age-related disease and disability; lead to the prevention, treatment, and cure of disease; advance the standard of care for older people; and inform public decision-making.