More than 41,000 New Brunswickers walked out of Horizon Health Network hospital emergency departments before receiving treatment in 2024-25, according to a new report by an independent public policy think tank.
That represents 12.9 per cent of all Horizon emergency room visits, compared with a national average of 7.8 per cent — giving New Brunswick the third-highest proportion of patients leaving an ER untreated among the nine provinces included, says the report by the Montreal Economic Institute, known as MEI.
Only P.E.I. and Manitoba had higher rates of people leaving without having been treated, at about 14 per cent and 13 per cent, respectively. Ontario had the lowest percentage at just under five.
“These patients are not leaving because they feel better, but because the system is failing them,” institute researcher Samantha Dagres said in a statement Thursday.
“Thousands of New Brunswickers are being denied access to care each year.”
WATCH | ‘This is not the kind of health-care system we want.’: 
Tens of thousands of New Brunswickers are leaving ERs without being treated, according to new report
New Brunswick had the third highest proportion of ER patients walking out before being treated last year among the nine provinces included in a report by the Montreal Economic Institute. That’s based on Horizon data alone, since Vitalité data is not included.
The New Brunswick walkout rates do not include Vitalité Health Network data. The province’s francophone health authority did not respond to a right to information request seeking the data filed by the Montreal Economic Institute in April or numerous followup emails, according to Dagres.
“While the data we received from Horizon doesn’t paint a pretty picture, Vitalité Santé’s failure to respond to our requests for information is especially troubling,” she said.
“You can’t fix what you can’t measure.”
Vitalité reports 22,000 walkouts
On Friday, Emmanuelle Faubert, an economist with MEI and the author of the report, told CBC’s Information Morning Moncton that Vitalité did provide some data, but it was “incomplete.”
It was “too far from what we asked to be able to include it in the report,” she said.
Later in the day, Vitalité CEO Dr. France Desrosiers, in response to a Thursday request from CBC News, issued a statement seeking to “clarify.”
“The Institute asked us to provide the data presented according to a methodology different from the one used by the emergency services management to monitor the performance of our emergency departments, and this within a tight deadline,” she wrote.
“Given our limited analytics resources during the period in question — one person handling a workload that would normally require six employees — we had to prioritize an urgent request from the provincial government related to the fiscal year.
“That said, we continuously monitor this data, as it is essential for improving our services and the patient experience. We were unable to provide it to the Institute in time, but we are making it available to you in full transparency.”
The data shows nearly 22,000 Vitalité patients walked out between January and December 2024, representing 11.5 per cent of all ER visits.
That’s up from about 19,000 the year before, or roughly 11 per cent.
Most are semi-urgent, non-urgent patients
Horizon recorded more than 320,000 emergency room visits in 2024. The report says most of the Horizon patients who left untreated were assessed as being level 4Â or 5, representing semi-urgent and non-urgent cases.
Examples might be a patient with a cut that requires stitches but the bleeding has been controlled (level 4) or a patient needing a dressing changed or a prescription renewed (level 5).
Across Canada, one in two patients who left an ER before being treated last year had been classified as a semi-urgent or non-urgent case, according to the MEI report. (Medical-R/Shutterstock)
“While these patients do not have the most pressing of medical needs, they still need care, without which their condition may worsen,” the report said.
Patients who leave without being evaluated or treated “can underestimate the true gravity of their situation, thus running the risk that their condition will deteriorate,” the report added.
“This premature departure can increase the risk of complications, or even death.”
Walkouts ‘unacceptable,’ Horizon executive says
Horizon takes the report seriously, said Greg Doiron, the organization’s vice-president of clinical operations.
“Every patient who leaves our emergency department without getting care is someone who needed care, and that’s unacceptable to us,” he said.
“This is not the kind of health-care system we want.”
‘Every patient who leaves our emergency department without getting care is someone who needed care, and that’s unacceptable to us,’ said Greg Doiron, vice-president of clinical operations for Horizon, shown here in a file photo. (Submitted by Horizon Health Network)
The report shows the percentage of Horizon patients leaving ERs without being seen has been rising recently, with the exception of a dip in 2023.
It was about 9.5 per cent in 2021, jumped to more than 12 per cent in 2022, dipped to just under 12 per cent in 2023 and then increased to 12.9 per cent in 2024-25.
That kind of increase reflects a trend nationwide, according to the report, which does not include Saskatchewan data.
Information Morning – MonctonNew report suggests tens of thousands of New Brunswickers are leaving emergency rooms without being treated
Emmanuelle Faubert is an economist with the Montreal Economic Institute and the author of a report on emergency room visits.
More than 1.2 million Canadian patients left ERs untreated last year, representing about one in every 13 visits. That’s up nearly 36 per cent since 2019.
Doiron said the issue is “multifaceted,” but went on to say one of the biggest challenges involves what are called alternate level of care or ALC patients. That’s the number of people occupying hospital beds while they await a room in a long-term care facility.
Horizon currently has a year-to-date average of nearly 635 ‘alternate level of care’ patients occupying hospital beds, up from 592 last year, according to its performance dashboard. The health-care network’s target is 330. (Shutterstock)
More than 40 per cent of Horizon’s inpatient beds are currently occupied by patients who “would otherwise get care in [the] community if the appropriate resources existed,” Doiron said, describing that statistic as one of the highest ALC rates in the country.
“This has an impact on our ability to provide emergency care because we have many, many patients who end up being admitted and cared for in the emergency department, taking up valuable emergency space, that ultimately limits our ability to provide the necessary access to patients for care when they urgently need it.”
Access to primary care a factor
Doiron said another factor contributing to the ER walkout rates is the number of New Brunswickers who don’t have a primary-care provider, such as a family doctor or nurse practitioner, and resort to visiting emergency departments instead.
Horizon continues to work “aggressively” to create new models of primary care to serve those people, he said.
The network is also working with various partners to find solutions to the ALC issue, Doiron said. This includes identifying ways to discharge patients back to their homes or to long-term care placements faster, and finding alternate routes for patients who need less-acute care, such as urgent treatment centres and diversion clinics.
MEI recommendations
The Montreal Economic Institute recommends increasing access to what it calls “upstream care.” This includes:
Increasing the use of specialized nurse practitioner clinics. Granting the broadest scope of practice to pharmacists, letting them advise people on minor medical matters that family doctors have traditionally handled. Allowing for the creation of non-governmental immediate care medical centres, based on the French model, to treat non-life-threatening emergencies.
“Solving the crisis in primary care is essential if we want to keep patients from continuing to fall through the cracks,” Dagres said.
“Policymakers must find the political courage to open up health-care delivery to independent and alternative providers, or else this crisis is bound to get worse.”