An increasing number of Americans are languishing in ERs for hours or even days, waiting for a hospital bed to open for them, a new study says.

More than 25% of ER patients who require admission for hospital treatment wind up “boarded” – biding four or more hours in spare rooms or busy hallways until a bed becomes available, researchers reported recently in the journal Health Affairs.

That number increases to 35% during the winter months, when infectious diseases lead to more emergency hospitalizations, researchers said.

Worse, nearly 5% of patients admitted during the peak winter months waited a full day for a bed, and nearly 3% waited that long during off-peak months, results showed.

“This growth in long boarding times for admitted patients is the most important driver of crowded conditions and long wait times in emergency departments,” said lead researcher Dr. Alex Janke, an emergency physician at the University of Michigan.

“Long boarding times increase patient safety risks, and delay needed care, while making it difficult for emergency departments to see new patients as they arrive,” Janke added in a news release. “Sustained high levels of boarding, as we have seen over the past three years, suggest the health system is at risk of collapse in the event of another pandemic.”

For the study, researchers analyzed health records of 1,500 hospitals in all 50 states from 2017 through September 2024.

They found that boarding had started to increase prior to the COVID-19 pandemic, but its rise accelerated starting in mid-2020 and has remained high ever since.

The practice hit its peak in January 2022, when 40% of patients boarded in an ER for more than four hours and 6% for 24 hours or more.

By 2024, the average percentage of patients waiting four or more hours for a bed was higher than it had been during the worst times of year in 2017 to 2019.

Nowadays, the number of patients waiting more than 12 hours for a bed rarely drops below 5%, even though that was a rare occurrence prior to the pandemic, researchers said.

Boarding has grown nationwide and in all patient groups, but the Northeast has the highest rate of boarding for 24 hours or more, researchers found.

“Our work highlights the need both to prepare for winter peaks and to address years-long mismatches between acute care demands and available resources,” the researchers concluded.