The average U.S. resident will visit the emergency room (ER) 34.5 times in their life. From accidents to chronic illnesses, each year, there are four visits per 10 people. With such high numbers of visitors to the hospital’s busiest department, long waits are expected. But which states have the longest emergency room waits?
Interested to find out, the firm Nursa has analysed emergency room visit data from every state to reveal the states with the longest and shortest ER waits.
The states with the longest emergency room waits in the U.S.
| Rank | State name | Hospital emergency room visits per 1K population (2023) | Percentage of patients who left the emergency department before being seen (%) (2024) | Average time patients spent in the emergency department before leaving (mins) (2024) |
| 1 | Maryland | 303 | 4 | 4h 11m |
| =2 | Massachusetts | 473 | 5 | 3h 40m |
| =2 | Rhode Island | 464 | 5 | 3h 40m |
| 4 | Delaware | 438 | 5 | 3h 34m |
| 5 | Connecticut | 481 | 2 | 3h 17m |
| 6 | New York | 452 | 3 | 3h 13m |
| 7 | North Carolina | 432 | 3 | 3h 12m |
| 8 | Vermont | 439 | 2 | 3h 5m |
| 9 | New Jersey | 369 | 2 | 3h 4m |
| =10 | California | 346 | 2 | 3h 2m |
| =10 | Pennsylvania | 489 | 2 | 3h 2m |
According to Nursa, people in the U.S. spend an average of 2 hours and 35 minutes in the emergency department, less than half the wait times in the UK, which a study averages to be 5h 18m. The US is currently facing a nursing shortage, causing strain on the US healthcare system, nurses themselves, patient outcomes, and patient waits. Staffing shortages heavily impact the speed and quality of care in ERs from initial triage to bed turnover, which is a potential factor as to why 2.5% of peoples leave the medical facility before being seen.
According to data, the top principal reasons that people visit the ER include: stomach and abdominal pain, cramps and spasms (8.9%), chest pain and related symptoms (5.6%), shortness of breath (4.2%), cough (3.3%), fever (3.3%), and headache, pain in head (2.8%).
In terms of specific areas, the table shows that Maryland residents spend, on average, 4h 11m in the ER before leaving – 62% longer than the national average of 2h 35m. Maryland also has the fifth fewest ER visits per 1K people at 303, much lower than the top state, West Virginia, which sees 596 visits per 1K people.
Maryland’s ER waits can be attributed to many factors, but Nursa’s previous study, The 2025 Health Recovery Index, which reveals the best and worst states to recover from illness, places Maryland as the 6th worst state to recover from illness. With a nurse supply of 7.37 per 1k people, 4.44 physician supply per 1k people, and just 1.81 hospital beds per 1k people, all contributing to Maryland’s lengthy ER waits. Luminis Health Anne Arundel Medical Center in Annapolis was the 55th most visited emergency department in the US for 2024, with 101,029 visits.
In joint second place, Massachusetts and Rhode Island both see ER waits of 3h 40m – 42% longer than the national average of 2h 35m. In fourth place, Delaware residents can expect a 3h 34m ER wait, and rounding up the top five is Connecticut with a wait of 3h 17m.
On the flip side, Emergency rooms in North Dakota have the shortest waits, with the average patient spending just 1h 50m in the department. North Dakota has the fifth most nurses per 1k people at 12.4 and the 23rd most physicians (3.61 per 1k people). The state also has the second most hospital beds per 1k people, with 4.13, and the second most hospitals per 1k people, with 0.058. Following on from North Dakota, the shortest ER waits include Nebraska (1h 52m), South Dakota (1h 53m), Hawaii (1h 53m), and Oklahoma (1h 57m).
