With the festive season just around the corner, emergency departments are expecting to be swamped with patients for reasons from increased alcohol consumption to seasonal sickness. However, some states cope with a high demand for emergency care better than others.
A new study by Whitley Law Firm has examined data from the Centers for Medicare & Medicaid Services (CMS) to determine the best and worst states to be injured in.
The analysis identified the median time spent in the emergency department before leaving, ranking the states based on the longest to shortest times.
Top 10 states spending the most time in the emergency department
Rank | State | Median minutes patients spent in the emergency department before leaving |
1. | Maryland | 251 |
2.(=) | Massachusetts | 220 |
2.(=) | Rhode Island | 220 |
3. | Delaware | 214 |
4. | Connecticut | 197 |
5. | New York | 193 |
6. | North Carolina | 192 |
7. | Vermont | 185 |
8. | New Jersey | 184 |
9.(=) | California | 182 |
9.(=) | Pennsylvania | 182 |
10. | Arizona | 179 |
Maryland was revealed as the worst state to be injured in, spending 251 minutes in the emergency department before leaving. Patients receiving emergency treatment in the state were there for over four hours.
Massachusetts and Rhode Island followed in joint second, each with a median time of 220 minutes spent in the emergency department.
In third was Delaware, with a median of 214 minutes spent in the emergency department, whereas ranking fourth was Connecticut with a time of 197 minutes.
New York and North Carolina followed in fifth and sixth place, with 193 and 192 minutes spent in the emergency department, respectively.
In seventh was Vermont, with patients expected to spend 185 minutes before being able to leave the emergency department. New Jersey ranked eighth with 184 minutes.
Occupying the ninth slot were both California and Pennsylvania, with 182 minutes spent in the emergency department, or just over three hours.
The state rounding out the top 10 was Arizona. Just short of a three-hour period, patients in the state spent 179 minutes in the emergency department before being able to leave.
Top 10 states spending the least time in the emergency department
Rank | State | Median minutes patients spent in the emergency department before leaving |
1. | North Dakota | 110 |
2. | Nebraska | 112 |
3.(=) | Hawaii | 113 |
3.(=) | South Dakota | 113 |
4. | Oklahoma | 117 |
5. | Kansas | 122 |
6. | Iowa | 123 |
7. | Montana | 126 |
8.(=) | Minnesota | 129 |
8.(=) | Mississippi | 129 |
9.(=) | Louisiana | 131 |
9.(=) | Utah | 131 |
10.(=) | Colorado | 132 |
10.(=) | Wyoming | 132 |
At the other end of the spectrum were states with more manageable durations. Patients in North Dakota spent a median of 110 minutes in the emergency department before leaving, which was under half the time of the state with the longest time spent.
Nebraska followed closely behind with 112 minutes spent in the emergency department before leaving, whereas both Hawaii and South Dakota had relatively short times of 113 minutes.
The fourth shortest time spent was recorded in Oklahoma, with a median of 117 minutes. Kansas rounded out the top five best states to be injured in according to their time spent in the emergency department, with a median of 122 minutes.
Other states with relatively low times spent in the emergency department before leaving were Iowa (123), Montana (126), Minnesota (129), Mississippi (129), Louisiana (131), Utah (131), Colorado (132), and Wyoming (132).
A spokesperson from Whitley Law Firm commented on the findings:
“This study offers a fascinating insight into the varying times that patients can expect to spend in an emergency department depending on where they are in the country. Prolonged times in emergency departments can have serious consequences for patient outcomes, and the difference in timings is considerable, with some states at the top of the list seeing a median time spent in the ER that is more than double that of the states with the shortest time.
“There are plenty of factors that can result in longer emergency wait and treatment times for patients, such as healthcare system capacity, population demographics, policy decisions, and geographic factors. States with fewer emergency departments per capita or with staffing shortages tend to have longer waits, as overwhelmed hospitals struggle to keep up with demand. In areas where primary care or urgent care access is limited, more people rely on emergency services for non-urgent issues, increasing congestion.
“Population density plays a role as well, since urban centers often see high volumes of emergency visits, while rural areas may face delays due to limited facilities and long travel distances. Demographics can also have an impact, as states with older or poorer populations typically experience higher emergency room usage.
“Policy decisions, such as Medicaid expansion and state-level healthcare funding, influence how easily residents can access alternative forms of care, which in turn affects how long each patient spends in the emergency department. Additionally, hospitals that use efficient management systems, technology, and data-driven triage tend to handle patient flow better and reduce delays. High call volumes, case severity, and delays in moving patients from the emergency room into inpatient beds also contribute to extended times in many states.”
Post courtesy: https://whitleylawfirm.com
Methodology: This study analyzes data from the Centers for Medicare & Medicaid Services (CMS) on the time spent in the emergency department before leaving, published on 6th August 2025. The median times in the emergency department for each state were extracted and then used to rank the states from the longest to the shortest.
Source: CMS - https://data.cms.gov/provider-
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