The number of emergency hospital admissions in Northern Ireland is expected to rise by around 13,000 by the middle of the next decade unless patterns change, an official report said.
A baby-boomer generation entering retirement will be responsible for the increase.
Over recent years hospitals have come under intensifying pressure due to the effect of the seasonal flu and another difficult period is anticipated this winter in Northern Ireland.
The older population rise by 2026 of 74,500 will be equivalent to twice the size of Ballymena, chief medical officer Dr Michael McBride said, and health service bosses have launched a review of how emergency care is delivered.
Standardised arrangements for local urgent treatment centres giving access to a range of tests and care could help meet the challenge, retired public health doctor David Stewart said after he reviewed future health needs.
Department of Health permanent secretary Richard Pengelly said: “The current model for urgent and emergency care in Northern Ireland is unlikely to keep up with the changing needs of our population in the years ahead.”
It is projected the total number of emergency admissions will rise by around 13,000 between 2016-17 and 2025-26.
The population aged under 65 will fall by around 13,000 admissions and for those over 65 the number of admissions is expected to rise by around 26,000.
Mr Stewart said there was a growing demand for urgent care.
By the time people reach 85, more than a quarter of patients discharged from hospital will need support in the community, such as at nursing homes.
Currently the proportion waiting longest for emergency admission were those aged over 75, many waiting more than 12 hours.
The number of emergency or urgent patient journeys by ambulance has risen consistently since 2005.
As people get older the number of people suffering major traumatic injury through falls over less than two metres increases, statistics revealed by Mr Stewart showed.
He said the focus should be on creating the most appropriate arrangements for the assessment and admission of older people with medical conditions.
Mr Pengelly added: “Improvements in the integration of primary and secondary care services will be among the priorities, as well as the provision of more urgent treatment centres, such as the facility recently opened at Omagh Hospital.”