Health Care Wait Times: How Long Do Americans Spend In Hospital Emergency Departments?

When you need emergency medical care, waiting in hospital emergency departments can feel like it takes forever, especially as more patients arrive and the waiting room fills. When you’re worried about a loved one or your own health, this can create a real sense of dread and put people off seeking emergency care.

To understand how emergency departments are performing and help to reveal the areas where emergency departments have the longest and shortest average wait times, we reviewed Centers for Medicare and Medicaid Services (CMS) data to share insights on the states and local areas where it takes the longest to get seen, transferred to another facility, and/or discharged.

Time Spent In Emergency Departments By State

State data from the Centers for Medicare and Medicaid Services (CMS) show that the average time spent in an emergency department is 2 hours and 40 minutes (160 minutes), including the District of Columbia and Puerto Rico.

Looking at states only, our analysis of CMS data from October 1, 2024, to September 30, 2025 (the latest annual data available), found that the average time spent was 6 minutes shorter, averaging 154 minutes, or 2 hours and 35 minutes.

Outside the jurisdictions of the District of Columbia and Puerto Rico, Maryland has the longest time-spent figures of any state. On average, patients in Maryland hospital emergency departments spend over 4 hours (246 minutes) in the facility before leaving.

This long duration likely contributes to the 3% of visitors to Maryland hospital emergency rooms who leave before they’re seen. However, the District of Columbia has the highest rate, with 6% of all patients leaving before being seen, while Delaware has the second-highest rate (5%).

This table shows the states where patients are in the emergency department for the longest times.

In contrast to DC or Maryland, North Dakota has the shortest emergency department times, with patients spending only 110 minutes (1 hour 50 minutes), while Nebraska has the second-shortest duration (113 minutes).

However, while North Dakota’s emergency department duration is less than half of Maryland’s (and nearly three times shorter than DC’s), the percentage of patients who leave before being seen matches Maryland’s (3%).

Among the ten best-performing states for time spent in emergency departments, Nebraska, Hawaii, and South Dakota all have early exit percentages of just 1%. The table below shows the states with the shortest durations spent in emergency departments and the percentage of patients who leave before being seen.

Time Spent In Emergency Departments By Local Area

State data provide invaluable insight; however, while sitting in emergency waiting rooms, or waiting to be given the green light to go home, patients are far more interested in seeing and understanding how their local hospital performs.

Our analysis of local areas used CMS hospital data to identify counties with the longest and shortest emergency department wait times.

Across the counties and parishes we analyzed, Manati and San Juan in Puerto Rico had the longest durations of patients in emergency departments before being transferred to another facility or department, or discharged. CMS figures show emergency department visits in Manati average 381 minutes, or 6 hours and 21 minutes, before patients are allowed to leave. And, for those needing emergency care in San Juan, emergency department duration averaged 347 minutes, or 5 hours and 47 minutes.

Within the continental United States, Dougherty in Georgia has the longest emergency department duration times, with patients facing 5 and a half hours (330 minutes) before they are typically discharged or transferred to another department or facility.

Of the ten counties and parishes with the longest average duration times, three are located in Puerto Rico, while two each are located in the states of New York (Albany and Saratoga) and North Carolina (Pitt and Durham).

The table below shows the counties and parish areas with the longest average durations that patients face when visiting local emergency departments.

At the other end of the scale, our analysis found that patients needing to use an emergency department in Roberts, South Dakota, have the shortest duration. Figures reveal that patients spend just 44 minutes in the ED before being transferred or discharged.

Behind Roberts is Rio Grande, Colorado, where patients typically only spend 45 minutes in the emergency department. Rounding out the three counties and parishes with the “quickest” emergency departments is Mitchell, Texas, where patients spend 48 minutes.

The table below shows the ten counties and parishes with the shortest emergency department durations.

Impact on the Elderly

The average patient in our analysis spends 160 minutes in the emergency department. For an older adult, those nearly three hours can be consequential in ways that last well beyond the visit.

“For a healthy 30-year-old, three hours in the ER is frustrating. For an 85-year-old with dementia, frailty, or several chronic conditions, three hours can be destabilizing. They may miss medications, go without food or water, become disoriented in an unfamiliar environment, or lose strength from spending hours in a bed or chair,” said Jenny Lee, CEO at Hera Geriatric Care Management.

In places where waits stretch beyond five hours, as they do on average in Washington, D.C. and Dougherty County, Georgia, those risks become even more pressing.

“The ER can actually become part of the health event itself. We see older adults go in for one problem and come out weaker, more confused, and often with an entirely new set of things their family has to manage.”

The effects also extend beyond the patient.

“After hours in the ER, older adults and their families are often sent home with new medications, follow-up appointments to arrange, and warning signs to watch for. These families are depleted by the visit, and even more so by the work to keep their loved one’s care going. We often see one family member end up shouldering the burden. It shouldn’t have to be that way.”

Methodology

Our analysis of Timely and Effective Care data from the Centers for Medicare and Medicaid Services examined state and county/parish time-spent figures. We sourced state and jurisdictional (District of Columbia and Puerto Rico) data directly from CMS datasets, while we collated county/parish data from hospital data, averaging by county/parish name and state codes.

To ensure consistent review, we examined data from the OP_18b and OP_22 data classifications. The OP_18b data reflects the average (median) time patients spent in the emergency department before leaving and excludes patients transferred to another facility or psychiatric care/mental health patients, while the OP_22 data shows the percentage of patients who left the emergency department before being seen.

In total, CMS data provided county and parish statistics from 2,305 local areas across 4,081 health facilities.