Americans spend a median of two hours and 40 minutes in the emergency department, and 2.2 percent leave before being seen, according to a new analysis of federal hospital data.
LawyerSEO.Marketing ranked the 50 states using Centers for Medicare & Medicaid Services figures on timely and effective care, published Feb. 25, 2026. The ranking is based on median time spent in the emergency department before departure, including discharges, transfers and psychiatric patients, from April 1, 2024, through March 31, 2025.
Maryland ranked worst. Patients there spent four hours and 13 minutes in the ER, and 3 percent left before being seen.
Massachusetts placed second at three hours and 49 minutes, with 4 percent leaving unseen. Rhode Island ranked third at three hours and 45 minutes. Delaware was fourth at three hours and 43 minutes and posted the highest walkout rate in the country: 5 percent, or one in 20 patients.
New York ranked fifth at three hours and 20 minutes, though only 2 percent left before being seen. Connecticut, North Carolina, Vermont, Pennsylvania and New Jersey completed the top 10. Arizona and California also averaged more than three hours.
Hawaii had the shortest median time at one hour and 53 minutes. North Dakota, Nebraska and South Dakota all finished under two hours.
“Notably, ER processing times in the US do not account for patients who may need urgent care but do not, for whatever reason, visit a hospital,” says Dr M Mansoor Siddique, Director of LawyerSEO.Marketing. “A key factor is the potential financial burden medical bills can pose, especially for the 8.2% of US residents without health insurance.
“When someone gets injured in a car crash, for example, and does not appear serious at first, a four-hour wait time in the ER can be life-threatening.
“If you are visiting Maryland, Massachusetts, Rhode Island, Delaware or New York, in particular, and unfortunately need urgent care, please be extra cautious and persistent in advocating for yourself. You could, at the very least, ask a triage nurse for a time estimate. Hospitals in these states need intervention to become better resourced to deal with higher demand in densely populated areas and to cut down on valuable patient and medical staff time.
“Beds are often full because patients who should be moved to step-down care facilities have nowhere to go, so new arrivals are left waiting.”
The walkout rates were included for context and did not affect the ranking. Averages exclude Washington, D.C., and U.S. territories.
