Rising Emergency Department Demand Among Older Adults in Ireland: Trends, Drivers, and Forecasting Implications

Abstract Background Emergency Department (ED) attendances among adults aged 65 years and older are rising both in absolute numbers and as a proportion of all attendances in many developed healthcare systems. A clear understanding of the scale and trajectory of this growth is important for effective system planning, workforce development, and the creation of emergency care pathways tailored to older adults. Methods We conducted a retrospective analysis of national ED attendance data from 2016 to 2024, focusing on adults aged 65 years and older. These patterns were analysed in the context of national census data from 2006 to 2022. Attendances per 1,000 population were calculated to assess changes in per-capita ED utilisation. Linear projection models were developed to estimate future demand to 2030. Results From 2016 to 2024, total ED attendances in Ireland increased by 22%, while attendances among those aged 65+ rose by 46%, from 110,429 to 161,283. The proportion of all ED attendances attributed to this age group rose from 8.5% to 10.2%. Attendance growth was steeper among the oldest patients, with 72% growth observed in the 95+ age group. Population ageing was a key driver: the number of adults aged 65+ increased by 21.8% between 2016 and 2022. ED attendances per 1,000 adults aged 65+ increased, from approximately 173 to 198, reflecting possible changes in health status, referral practices, care-seeking behaviour and/or reduced access to alternative services. . Projections indicate attendances in this age group could exceed 218,000 annually by 2030, comprising 12–13% of total ED demand. Conclusion Older adults represent a rapidly growing and increasingly complex ED population. Rising per-capita utilisation alongside demographic ageing suggests that demand cannot be managed solely through increased capacity. Strategic responses must include investment in emergency care pathways tailored to older adults, age-friendly infrastructure, improved integration across services, care navigation and prevention and community-based alternatives.