A 2024 Annals of Emergency Medicine study estimated that boarding a med-surg stroke patient in the ED cost $1,856 a day, against $993 for the same patient on a ward.
$1,856
a day per boarded med-surg stroke patient
A 2024 Annals of Emergency Medicine study estimated that boarding a med-surg stroke patient in the ED cost $1,856 a day, against $993 for the same patient on a ward.
The study covered patients with acute stroke at one large academic stroke center. For ICU-level patients, boarding cost $2,267 a day against $2,165 in the ICU.
Source: Canellas MM et al., Measurement of Cost of Boarding in the Emergency Department Using Time-Driven Activity-Based Costing, Annals of Emergency Medicine 84(4) (opens in a new tab), Abstract, Results. Verified October 2026.
Related charts
- From the blog
A boarded med-surg stroke patient cost nearly twice as much a day as one on a ward
Canellas et al., Annals of Emergency Medicine, vol. 84 (2024) - From the blog
Hopkins assigned ED patients a bed 30% faster after opening a command center
Johns Hopkins Medicine, Capacity Command Center news release (October 2016) - From research
Hospital drug expenses grew 13.6% in 2025, nearly twice as fast as total expenses
American Hospital Association, Costs of Caring 2026 (March 2026) - From the blog
Length of stay rose most for patients going to psychiatric hospitals or skilled nursing
American Hospital Association, Increasing Delays in Timely Discharges issue brief (December 2022)
Sources for the figures above: Canellas MM et al., Measurement of Cost of Boarding in the Emergency Department Using Time-Driven Activity-Based Costing, Annals of Emergency Medicine 84(4) (opens in a new tab); The Johns Hopkins Hospital Launches Capacity Command Center to Enhance Hospital Operations (news release) (opens in a new tab); American Hospital Association, Costs of Caring 2026 (March 2026) (opens in a new tab); American Hospital Association, Increasing Delays in Timely Discharges issue brief (December 2022) (opens in a new tab).
Related facts
54%
of 195 emergency physicians surveyed reported violence tied to boarding
In a 2025 survey of 195 emergency physicians, published in Health Affairs Scholar, 54% reported experiencing violence related to emergency department boarding.
Source: Norton, Schreyer and Kuhn, Workforce impact of emergency department boarding, Health Affairs Scholar 3(8).
KentApplied30%
faster bed assignment for admitted ED patients
Johns Hopkins reported in 2016 that its new capacity command center assigned beds to admitted ED patients 30% faster.
Source: The Johns Hopkins Hospital Launches Capacity Command Center to Enhance Hospital Operations (news release).
KentApplied4 hours
of ED boarding before CMS's measure counts it
CMS's Emergency Care Access & Timeliness measure counts admitted patients who board in the ED for more than 4 hours.
Source: CY 2026 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center final rule, 90 FR 53448.
KentApplied
Sources for the figures above: Norton, Schreyer and Kuhn, Workforce impact of emergency department boarding, Health Affairs Scholar 3(8) (opens in a new tab); The Johns Hopkins Hospital Launches Capacity Command Center to Enhance Hospital Operations (news release) (opens in a new tab); CY 2026 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center final rule, 90 FR 53448 (opens in a new tab).
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