ACEM President Dr Peter Allely said that the College's the (SOE) report showed Australia’s ageing population should be seen as a success story, but one the health system has failed to plan for.
“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. 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.”
In 2023-2024, almost nine million people sought care in an ED. A quarter were aged over 65, and within that group more than half arrived by ambulance, nearly seven in 10 were triaged as needing more urgent care, and one in two were admitted to hospital, compared with fewer than one in four younger patients.
This is ACEM’s third SOE report. The first highlighted Australia’s acute healthcare crisis, while the second focused on regional, rural and remote Australia.
This edition draws on the accounts of emergency physicians alongside Australian government ED data and finds that pressures felt in the ED are largely the consequence of failure to invest in capacity across hospitals and residential aged care combined with a failure to invest in primary care and prevention.
Data trends also reveal:
- 53,510 older people spent longer than 24 hours in an ED awaiting a bed in 2023-24, almost 40,000 more than in 2018-19 (15,084)
- Only half (54 per cent) of older patients needing admission left the ED within the eight-hour target, compared to almost three-quarters (71 per cent) of younger patients — and that gap has widened sharply since 2018-19
- A projected 411 per cent increase in ED arrivals for those aged 85 and over by 2050
The report also finds that the challenges are a national issue, with EDs in regional, rural and remote areas experiencing even faster growth in older patient presentations than are those in metropolitan areas.
Extended waits in EDs 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.”
ACEM’s report contains a series of recommendations calling on Federal, State and Territory governments and hospitals to take urgent action.
“Unless these serious issues are addressed as a matter of urgency, emergency care will come too late for many Australians,” Dr Allely said.
“To date, Federal, State and Territory Governments have not done enough to prepare for the volume and complexity of acute care needs as the population ages.
“Without action, older people will continue to suffer harm due to extended stays in the ED as well as delayed discharge from hospital. 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.”
Download State of Emergency 2026 here.