Australia’s emergency departments are struggling to cope with the demands of an ageing population, with more than 53,000 older patients spending over 24 hours waiting for a hospital bed in 2023–24, according to a new report by the Australasian College for Emergency Medicine (ACEM).

The State of Emergency 2026: Australia’s Ageing Population report warns that inadequate investment in hospitals, residential aged care, primary care and preventive health services is placing growing pressure on emergency departments (EDs).

ACEM President Dr Peter Allely said Australia’s ageing population should be celebrated, but successive governments have failed to adequately prepare the health system for its consequences.

“Australians are living longer than ever before, and that’s something to celebrate,” Dr Allely said.

“But from the ED floor, we can see very clearly that successive governments haven’t planned for what success means for our health system.”

He warned that aged care pressures were spilling into emergency departments, with nearly one in five Australians projected to be aged 65 and over by 2030.

“Our health system and its workforce are just not equipped for this demographic change,” he said.

Older patients face longer waits

The report found that almost nine million people sought emergency department care in Australia during 2023–24, with one in four patients aged over 65.

Among older patients, more than half arrived by ambulance, nearly seven in 10 were triaged as requiring more urgent care, and half were admitted to hospital.

By comparison, fewer than one in four younger patients were admitted.

The number of older people spending more than 24 hours in an emergency department while waiting for a hospital bed reached 53,510 in 2023–24, up from 15,084 in 2018–19.

The report also found that just 54 per cent of older patients requiring admission left the emergency department within the eight-hour target, compared with 71 per cent of younger patients. The gap has widened significantly since 2018–19.

ACEM warned that prolonged waits in emergency departments and hospital corridors can leave older people, particularly those who are frail or in pain, without adequate rest, nutrition and dignity. Some patients may deteriorate while waiting for a ward bed.

Demand expected to surge further

The pressure is expected to intensify as Australia’s population ages.

The report projects a 411 per cent increase in emergency department presentations among people aged 85 and over by 2050.

Regional, rural and remote emergency departments are also experiencing faster growth in older patient presentations than metropolitan services, highlighting the national scale of the challenge.

The growing demand is affecting healthcare workers as well as patients, with the report describing the emotional toll on emergency physicians who witness preventable harm caused by prolonged waits.

One emergency physician quoted in the report said: “The daily witness of this avoidable injury also causes moral injury and burnout in staff – this is not the care any of us want to see older persons (those who once cared for us) receive.”

Calls for urgent government action

The report calls on federal, state and territory governments, as well as hospitals, to take urgent action to improve capacity across the healthcare system.

ACEM argues that addressing emergency department overcrowding requires more than changes within hospitals. Greater investment in residential aged care, primary healthcare and preventive services is also needed to ensure older people receive appropriate care before their conditions become emergencies and can leave hospital safely when treatment is complete.

“Unless these serious issues are addressed as a matter of urgency, emergency care will come too late for many Australians,” Dr Allely said.

He warned that without action, older Australians would continue to face harm from extended emergency department stays and delayed hospital discharge.

“We all need to know that as we age, we’ll be treated with respect and dignity and have access to high quality and timely care,” he said.

ACEM is the peak body for emergency medicine in Australia and Aotearoa New Zealand, responsible for training emergency physicians and advancing professional standards.

The State of Emergency 2026 is the College’s third report examining pressures on Australia’s emergency care system, following earlier reports focused on the acute healthcare crisis and regional, rural and remote Australia.

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