How London’s ER overflow affects smaller regional hospitals

Factors including population growth and capacity limits are contributing to longer wait times at London Health Sciences Center emergency departments, prompting people to visit smaller nearby hospitals for treatment and driving up volumes there, including in St. Thomas whose hospital saw one of its busiest days ever just after Christmas. Here are some things to know about ER wait times.

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WHY ARE ER WAIT TIMES IN LONDON LONGER?

Several factors are contributing to longer wait times at LHSC’s two London emergency room locations, said Lauren Cipriano, a management science professor at Western University‘s Ivey business school, with expertise in epidemiology and biostatistics.

Cipriano cited a shortage of ER nurses, higher demand for ER services due to a lack of family doctors for 15 to 20 per cent of people, cold and flu season and a surging population.

“London is going to be worse than other places in the province, because we’ve already been behind on service level per capita,” Cipriano said.

London and Middlesex County already has ballooned by 60,000 people in the last five years and is expected to grow by 56.7 per cent during the next 25 years, the Ontario Ministry of Finance said in population projections released in fall 2024.

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WHERE ARE LONDONERS GOING?

Cipriano said the part of the city in which Londoners live could determine where they travel to seek ERs with shorter wait times.

Residents are traveling to St. Thomas, but people living in London’s west could be heading to Strathroy Middlesex General Hospital (SMGH) and residents in the city’s east could be driving to Woodstock Hospital, she said.

“People are traveling from London to St Thomas because they expect shorter wait times, and that’s not unreasonable of them (because) there are shorter wait times in St Thomas,” Cipriano said.

St. Thomas Elgin General Hospital said in an email it has received more patients from multiple counties, but noted an increase in visitors from London and Middlesex County in recent years.

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“Visits from Middlesex (and) London (patients) have increased from 11 per cent in 2021-22 to 16 per cent in 2022-23,” the hospital said. “This growth reflects both overflow and patients’ decisions to seek care at our facility.”

The Strathroy hospital stated in an email the ER receives visits from residents of other communities including London.

“We do hear anecdotally from patients that they chose to come to SMGH because they think the wait time will be less than at LHSC,” the hospital statement said.

Woodstock Hospital didn’t respond to The Free Press’ request for comment.

WHAT ARE THE WAIT TIMES?

According to Health Quality Ontario’s website, the average wait time to see a doctor at an ER in Ontario is about two hours. However, that average wait time doesn’t represent the average time patients spent at the hospital.

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Cipriano said there is a data lag on Health Quality Ontario’s website. In October 2024, the average wait time to see a doctor was nearly three hours at University Hospital and 2.5 hours at Victoria Hospital, according to the website.

Average wait times to see a doctor were 1.3 hours at Strathroy Middlesex General Hospital, 1.5 hours at St. Thomas Elgin General Hospital and 1.7 hours at Woodstock Hospital during the same timeframe, according to the website.

CONSEQUENCES OF MORE VISITORS TO SMALLER HOSPITALS

People heading to hospitals in smaller urban centers such as St. Thomas could theoretically drive the wait times in London down while causing wait times at regional hospitals to rise, equalizing wait times, Cipriano said. However, that could create a “substantial culture shift” because staff aren’t used to volumes seen at London hospitals, she said.

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On Dec. 27, 2024, St. Thomas Elgin General Hospital had “likely our busiest day ever,” the hospital said, with 90 per cent of people waiting nearly five hours before meeting with a physician. On the same day, the average wait time to meet with a doctor was nearly three hours and the longest a patient waited to see a physician was 7 1/2 hours.

The increased traffic was “multifactorial,” the hospital said, citing reduced holiday hours at walk-in clinics and respiratory season. Patients from Middlesex County and London accounted for 19 per cent of visits that day, higher than the 16 per cent year-to-date average “suggesting some overflow from London hospitals,” the hospital said.

London Health Sciences Center said the average wait time to see a doctor in its three emergency departments on Dec. 27 was 3.2 hours. The wait at Victoria Hospital was 3.7 hours while it was 4.8 hours at University Hospital and 1.5 hours at Children’s Hospital.

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The St. Thomas hospital said there is a concern about higher volumes from London and surrounding areas that may result in longer wait times “particularly for non-urgent cases,” but said individuals have the “freedom to access care at the facility of their choice .”

“This is certainly hard on small centers to have this much more demand, but they’re still not dealing with the high wait times of London,” Cipriano said.

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@BrianWatLFPress

The Local Journalism Initiative is funded by the Government of Canada

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