A CMS measure aims to limit older adults’ emergency department stays to eight hours, but in 2024, 20% of ED encounters among adults 65 and older exceeded this limit, according to research published June 30.
CMS implemented an Age-Friendly Hospital measure on Jan. 1 that requires hospitals to have initiatives to improve the quality of care for older adults. Those initiatives include keeping ED lengths of stay under eight hours and admitting patients within three hours of the decision to admit.
To examine trends related to the new CMS measure, researchers from Beth Israel Deaconess Medical Center in Boston analyzed data from nearly 17 million ED encounters in 2017 and 2024 among adults 65 and older.
In 2017, 12% of these encounters lasted longer than eight hours. By 2024, that share rose to 20%.
The study, published in JAMA, found that “the increase was most pronounced in academic hospitals, where the percentage of encounters with prolonged LOS increased from 19% in 2017 to 30% in 2024.”
For the three-hour admission goal, 22% of boarding patients with a bed request waited longer than three hours in 2017. That figure grew to 36% in 2024
Prolonged time in the ED for adults 65 and older is linked to higher risks of adverse events, including delirium and mortality, and can result in treatment delays, loss of privacy and poor patient experiences, according to the study.
“Worsening ED LOSs and boarding contribute to ED crowding, reflect systemic health care dysfunction, and, most importantly, harm individual patients,” the researchers wrote in conclusion. “Addressing these trends is critical to safeguarding both the health of older adults and the health systems caring for them.”
