Between the fourth quarters of 2024 and 2025, emergency department length of stay decreased 13.4% even as volumes grew 4.2% and patient acuity rose, according to a May 6 report.
The report is from Sg2, a healthcare analytics and consulting company at Vizient. Through its System of CARE Scorecard, Vizient measures hospital utilization, access, safety and cost efficiency each quarter. Its latest scorecard compared the fourth quarters of 2025 and 2024 for care coordination.
On a rolling year-over-year measure, ED length of stay declined 15.2% and volume increased 4.3%, according to the report. Vizient researchers hypothesized that improvements in throughput, shifting trends in patient mix or a combination of the two could be account for these findings.
Over a longer timeframe, when divided between community hospitals and academic medical centers, the former group recorded a larger decrease in ED length of stay. Between the first quarter of 2023 and the fourth quarter of 2025, average LOS fell 38% in community hospital EDs and decreased 23% at academic medical center EDs.
As hospitals weather a “new normal” of high capacity, ED boarding rates worsen and patient acuity rises, Vizient researchers posed these questions:
- Is a decline in ED ALOS at your hospital a sign of improved efficiency or does it result from a shift in patient mix?
- As ED length of stay declines, is your capacity keeping pace with rising volumes? Are those volumes marked by a shift in patient acuity?
- To what extent are length-of-stay trends driven by local payer dynamics, utilization trends, or operational improvements?
- How do case mix and patient acuity influence ALOS trends? Does newly available capacity create opportunity to meet new demand or strategically grow services?
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