The average American will visit the emergency room 34.5 times in their life. From accidents to chronic illnesses, each year, there are 4 ER 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, Nursa analyzed emergency room visit data from every state to reveal the states with the longest and shortest ER waits.
Study highlights
- Americans spend 2h 35m on average in the emergency department
- Maryland emergency rooms have the longest waits of 4h 11m
- North Dakota residents wait the shortest, at 1h 50m
- West Virginia residents visit emergency rooms the most (596 visits per 1k people)
- Nevada residents visit the least (226 visits per 1k people)
- 5% of patients leave the ER before being seen in Massachusetts, RhodeIsland, and Delaware - the highest rates in the US.
States with the longest ER wait times
Americans 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 Americans leave the ED before being seen.
According to 2021 data, the top principal reasons that Americans 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%).
Maryland residents spend the longest time in the ER
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.
Massachusetts sees 473 ER visits per 1k people - placing the 13th highest in the US. Massachusetts boasts the most physicians per 1k people (5.46) in the US and a large supply of nurses per 1k people, with 12.52. Despite having the most physicians and the fourth most nurses per 1k people in the US, the country as a whole is under the stress of the healthcare worker shortages. A staggering number of Bay Staters find themselves unable to find a primary care doctor or waiting weeks or months to get appointments, forcing many to attend urgent care or ERs just to be seen, making wait times worse. Massachusetts UMass Memorial Medical Center’s ER in Worcester had the 11th most ED visits in the US in 2024, with 137,107 visits.
Rhode Island is also in second place with 3h 40m waits in the emergency room; the state has among the fewest hospitals per 1k people, with just 0.01, adding extra stress to emergency rooms. Within the state, there is a nurse supply of 11.58 per 1k people and 4.37 physicians per 1k people.
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.
U.S. states with the shortest ER wait times
North Dakota residents spend the shortest time in the ER
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), SouthDakota (1h 53m), Hawaii (1h 53m), and Oklahoma (1h 57m).
Study methodology
- Nursa set out to determine the states with the longest and shortest ER waits.
- The average (median) time patients spent in the emergency department before leaving the visit, and the percentage of patients who left the emergency department before being seen (%) were sourced from the Centers for Medicare & Medicaid Services.
- The hospital emergency room visits per 1,000 population, the number of hospital beds, and the number of hospitals were sourced from KFF.
- The hospitals with the most emergency department visits in 2024 were sourced from Becker's Hospital Review.
- The nurses and physicians' supply was sourced from the Health Resources & Services Administration.
The data was collected in September 2025. The full dataset can be found here.
