ACEM’s latest report finds that emergency departments are unprepared for the demographic change of an ageing population. 

The Australasian College for Emergency Medicine’s (ACEM) third annual State of Emergency report shows clearly that Australia’s health system is not prepared for the growing number of older patients arriving in emergency departments. 

Australians are living longer than ever before, and that’s something to celebrate,” said ACEM president Peter Allely. “But from the emergency department floor, we can see very clearly that successive governments haven’t planned for what success means for our health system. Aged care pressures are spilling straight into emergency departments and, by 2030, nearly one in five Australians will be aged 65 and over. Our health system and its workforce are just not equipped for this demographic change,” he added. 

The report projects a 411% increase in emergency department arrivals for those aged 85 and over by 2050. 

The figures are stark. In 2023-2024, almost 9 million people sought care in an emergency department. A quarter were aged over 65, and within that group more than half arrived by ambulance, nearly seven in ten were triaged as needing more urgent care, and one in two were admitted to hospital, compared with fewer than one in four younger patients.

Four recommendations

The report also finds that the challenges are a national issue, with emergency departments in regional, rural and remote areas experiencing even faster growth in older patient presentations than are those in metropolitan areas.

Extended waits in emergency departments and hospital corridors mean older patients, often frail and in pain, are left without proper rest, nutrition or dignity, and can deteriorate while waiting for a ward bed. It is this everyday reality that takes a toll on both patients and the staff caring for them.

This mounting pressure on hospital EDs is also taking its toll on the workforce. 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.”

The report makes four recommendations. First, the need to strengthen alternative pathways to acute medical care for older people to reduce demand and hospital admissions; then to improve patient flow through emergency departments and reduce access block; next to expand prevention mechanisms to reduce emergency department attendance and hospitalisation through early intervention; and finally, to fund research into models of primary and acute care to improve outcomes for older people.