Hospital overcrowding can be measured through several connected indicators: how many beds are available, how full they are, how quickly emergency visits are completed, and how long admitted patients wait for an inpatient bed. The statistics below cover OECD countries, England, and historical U.S. evidence, with measurement periods kept explicit because these figures are not interchangeable.
Contents
- Hospital beds and occupancy across OECD countries
- Rising urgent and emergency care demand in England
- Emergency-department waits in England
- Admission bottlenecks and delayed transfers
- Seasonal pressure on English hospitals
- Emergency-department crowding in older U.S. evidence
Hospital beds and occupancy across OECD countries
The OECD average was 4.2 hospital beds per 1,000 population in 2023. More than 66% of OECD countries reported between 3 and 8 beds per 1,000 population, showing that the average sits within a broad range of national systems. Korea reported 12.6 beds per 1,000 population and Japan 12.5 in the same year. These are capacity measures, not a direct measure of how many beds were immediately staffed or available for every patient.
Capacity has also changed over time. Finland’s hospital-bed capacity per person fell by more than 50% between 2013 and 2023. Austria, Lithuania, Luxembourg, and the Netherlands each reduced hospital capacity by at least 1 bed per 1,000 population over that period. A lower bed supply can increase pressure when demand rises, although bed counts alone do not establish whether a particular hospital is overcrowded.
| OECD indicator, 2023 | Reported statistic |
|---|---|
| Average hospital beds | 4.2 per 1,000 population |
| Korea | 12.6 per 1,000 population |
| Japan | 12.5 per 1,000 population |
| Average curative acute-care occupancy | 72% |
| Average intensive-care beds | 17 per 100,000 population |
Occupancy provides a second view. Curative acute-care beds averaged 72% occupancy across OECD countries in 2023. Of the 29 countries with comparable data, two reported occupancy above 85%. The OECD measure uses available-bed-days, and country definitions and coverage vary, so the figures should be used for broad comparison rather than as a uniform overcrowding threshold.
Intensive-care capacity also varied widely. OECD countries averaged 17 intensive-care beds per 100,000 population in 2023. Czechia and Estonia each had around 40 or more intensive-care beds per 100,000 population, while New Zealand had fewer than 5. ICU definitions differ between countries, which limits direct comparisons.
Source: Hospital beds and occupancy: Health at a Glance 2025 | OECD.
Rising urgent and emergency care demand in England
England recorded 24.4 million attendances across its three main urgent and emergency care service types in 2021/22. By 2024/25, the total had reached 27.4 million. The increase was 12%, or 3 million attendances, over the period. The attendance rate rose from 43,100 to 46,700 per 100,000 people between 2021/22 and 2024/25.
Demand increased particularly among older age groups. Attendances by people aged 65–79 rose 20.5% between 2021/22 and 2024/25, while attendances by people aged 80–89 rose 18.6%. These figures describe attendance growth and do not by themselves show how many visits required admission or how many were avoidable.
The service mix also changed in 2024/25. Type 2 urgent and emergency care attendances grew 11%, adding 59,000 visits. Type 3 attendances grew 8%, adding 750,000. Type 1 emergency-department attendances grew 1.4%, adding 237,000. Across the same year, ambulance control rooms recorded 13,376,000 contacts, an increase of 283,000, or 2.2%, compared with 2023/24.
The pattern of ambulance response changed over a longer period. Hear-and-treat ambulance responses rose from just over 500,000 in 2018/19 to 1,417,493 in 2024/25. In the 2024 England urgent and emergency care survey, 66% of respondents who visited a type 1 emergency department had contacted another service first. Half of respondents who used a type 3 urgent treatment centre had done so.
Among respondents who went to a type 1 emergency department first, 26% said they wanted to be seen the same day, 16% said their condition was life-threatening, 20% said they did not think their GP could help, and 41% said they thought they might need a test. These percentages describe survey respondents, not all attendances.
Source: The state of health care and adult social care in England 2024 to 2025.
Emergency-department waits in England
Waiting-time statistics show how demand and capacity are experienced at the front door of hospitals. In the 2024 England urgent and emergency care survey, 64% of respondents said their emergency-department visit lasted more than 4 hours. Another 29% said it lasted at least 8 hours.
Annual administrative figures provide a wider service view. Across England’s three main urgent and emergency care service types, 74% of attendances were completed within 4 hours in 2024/25. The result was lower for type 1 emergency departments, where only 59% of attendances were completed within 4 hours. The survey and administrative measures are related but not identical: one describes respondent-reported visits, while the other covers recorded attendances.
Long waits were substantial. A total of 1,809,000 people waited more than 12 hours in urgent and emergency care in 2024/25. That total was 169,000 higher than in 2023/24, an increase of 10%.
The scale of the four-hour and 12-hour measures should be read alongside the service categories. The 74% figure combines type 1, type 2, and type 3 services, while the 59% figure applies specifically to type 1 emergency departments. The dataset does not support treating either percentage as a national measure for every hospital department.
Admission bottlenecks and delayed transfers
Crowding can continue after the clinical decision to admit, when a patient is waiting for an inpatient bed. England recorded 4.87 million admissions from its three main urgent and emergency care service types in 2024/25. Admissions were more than 90,000 higher than in 2023/24 and more than 200,000 higher than in 2021/22.
In 2024/25, 532,500 people waited more than 12 hours after the decision to admit. They represented 11% of urgent and emergency care admissions. In 2021/22, 98,600 people waited more than 12 hours after that decision, representing 2% of admissions.
| England admission bottleneck indicator | 2021/22 | 2024/25 |
|---|---|---|
| Admissions from three main service types | Not specified in the supplied figures | 4.87 million |
| Waited more than 12 hours after decision to admit | 98,600 (2%) | 532,500 (11%) |
| Average monthly count waiting more than 12 hours | 8,214 | 44,371 |
The average monthly count of people waiting more than 12 hours after the decision to admit rose from 8,214 in 2021/22 to 44,371 in 2024/25. This is a monthly average, not a count of unique people across the full period. It indicates a sustained change in the level of admission delay, while the annual total measures people recorded during the year.
Source: The state of health care and adult social care in England 2024 to 2025.
Seasonal pressure on English hospitals
England’s monthly average count of people waiting more than 12 hours after the decision to admit was 34,174 in 2022/23 and 36,618 in 2023/24, before reaching 44,371 in 2024/25. Bed occupancy remained high: general and acute bed occupancy averaged 93% during the three years covered by the CQC report and rose to 94% in winter months.
The average number of general and acute beds nevertheless increased from 95,000 in 2021/22 to 102,000 in 2024/25, a reported rise of 7.4%. More beds did not eliminate pressure because occupancy, demand, and delayed admissions are separate parts of the system.
A specific NHS England snapshot illustrates winter conditions. In the week ending 11 February 2024, 94.6% of England’s general and acute beds were occupied. England had 103,557 beds that week, compared with 100,855 in the same week of 2023. The average number of hospital patients was 97,934, compared with 94,562 in the comparable week of 2023.
Several infections contributed to the patient load in that week. England averaged 2,390 hospital patients with flu, compared with 737 in the same week of 2023. It averaged 565 patients with norovirus and 3,232 patients with COVID-19. These figures are a weekly snapshot and should not be treated as a full-year average.
Sources: The state of health care and adult social care in England 2024 to 2025; Hospitals under pressure with three times more flu patients than last year | NHS England.
Emergency-department crowding in older U.S. evidence
The U.S. figures available here are historical evidence summarized by the Agency for Healthcare Research and Quality, not current estimates. They should be kept separate from the 2023 OECD and 2024/25 England measures.
In evidence from 2006 or earlier cited by AHRQ, nearly 50% of U.S. emergency departments reported operating at or above capacity. The same evidence reported that 90% of U.S. hospitals boarded admitted patients in emergency departments while they waited for inpatient beds. It also estimated that approximately 500,000 ambulances were diverted away from the closest U.S. hospital each year.
A 2006 study at one large U.S. academic medical center associated each hour on ambulance diversion with $1,086 in foregone hospital revenue. This is a single-center historical finding, not a national estimate and not a current measure of financial impact.
Together, the older U.S. indicators show why overcrowding is often described as a flow problem: patients may be waiting for emergency assessment, an inpatient bed, or movement through the hospital, while incoming ambulances and new emergency visits continue. The figures do not establish a universal capacity threshold, and the historical period must remain attached to every comparison.
Source: Section 1. The Need to Address Emergency Department Crowding | AHRQ.