Which States Have the Best and Worst ER Care? The 10 Worst Might Surprise You!
A new study from Your Doctors Online reveals massive differences in emergency care access across the U.S. Using data from the U.S. Census Bureau, Centers for Medicare & Medicaid Services (CMS), and the Bureau of Labor Statistics, researchers analyzed ambulance availability, hospital access, EMT density, and ER wait times.
Key Findings
- The U.S. has an average of 16.03 ambulance stations and 36.58 hospitals/Medicare-certified ambulatory surgery centers (ASCs) per 10,000 square miles.
- There are 36.03 EMTs per 100,000 residents, but some states have far fewer.
- The national average ER wait time is 2 hours and 42 minutes, with wide variation between states.
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What Are the Best and Worst States for Emergency Care?
The study released by Your Doctors Online examined the best and worst states for emergency care based on several factors, including:
- Ambulance station per 10,000 square miles
- Hospitals and medicare-certified ambulatory surgery centers (ASCs) per 10,000 square miles
- Emergency medical technicians (EMTs) per 100,000 people
- Average time spent in the emergency room (ER)
- Overall ER score out of 100
The 10 Best States for Emergency Care
| Rank | State | Ambulance Stations per 10k sq.mi. | Hospitals & Medicare-certified ASCs per 10k sq. mi. | EMTs per 100k | Average Time Spent in ER | Overall ER Score /100 |
| 1 | Massachusetts | 176.92 | 230.77 | 52.75 | 3 hrs 36 min | 93.90 |
| 2 | Connecticut | 148.7 | 210.66 | 54.36 | 3 hrs 9 min | 91.83 |
| 3 | Delaware | 61.6 | 200.21 | 45.46 | 3 hrs 31 min | 87.28 |
| 4 | New Jersey | 232.53 | 497.69 | 40.05 | 3 hrs 11 min | 86.75 |
| 5 | Pennsylvania | 104.82 | 113.32 | 52.68 | 3 hrs 3 min | 86.20 |
| 6 | New York | 75.75 | 91.24 | 42.07 | 3 hrs 24 min | 81.63 |
| 7 | Rhode Island | 154.89 | 290.42 | 24.6 | 3 hrs 38 min | 76.53 |
| 8 | California | 27.51 | 87.01 | 43.22 | 3 hrs 6 min | 73.48 |
| 9 | Maryland | 52.54 | 426.5 | 19.75 | 4 hrs 10 min | 71.95 |
| 10 | Vermont | 40.15 | 19.53 | 91.75 | 2 hrs 59 min | 69.93 |
The 10 Worst States for Emergency Care
| Rank | State | Ambulance Stations per 10k sq.mi. | Hospitals & Medicare-certified ASCs per 10k sq. mi. | EMTs per 100k | Average Time Spent in ER | Overall ER Score /100 |
| 50 | Nebraska | 4.69 | 19.13 | 14.27 | 1 hr 54 min | 10.20 |
| 49 | Utah | 2.68 | 14.73 | 25.68 | 2 hrs 12 min | 15.80 |
| 47 | Kansas | 7.46 | 28.5 | 22.81 | 2 hrs 1 min | 17.35 |
| 47 | Idaho | 3.51 | 13.79 | 22.84 | 2 hrs 22 min | 17.35 |
| 46 | Alaska | 0.43 | 0.75 | 35.45 | 2 hrs 20 min | 20.40 |
| 45 | Iowa | 11.46 | 28.82 | 25.39 | 1 hr 59 min | 22.48 |
| 44 | South Dakota | 4.48 | 10.55 | 48.50 | 1 hr 53 min | 26.50 |
| 43 | Oklahoma | 10.64 | 28.28 | 34.10 | 2 hrs | 27.58 |
| 42 | Nevada | 4.74 | 13.12 | 34.14 | 2 hrs 24 min | 28.05 |
| 41 | Montana | 3.02 | 6.05 | 53.49 | 2 hrs 7 min | 30.10 |
Biggest Challenges
- Nebraska ranks lowest overall, struggling with EMT shortages and limited hospital access.
- Maryland has the longest ER wait times, averaging 4 hours and 10 minutes.
- North Dakota has the most EMTs per 100k residents (97.55) and the shortest ER wait time (1 hour and 50 minutes).
Why Efficient ER Care Matters
With 155 million ER visits in 2022, emergency care efficiency is critical. Raihan Masroor, CEO of Your Doctors Online, emphasizes the need for system-wide reforms:
"Personal preparedness matters, but it’s not enough. We need to expand ambulance coverage, address EMT shortages, and streamline hospital operations. Investments in telemedicine and mobile emergency units can help close these care gaps."
What Can Be Done?
States with poor emergency care response and wait times can make changes to improve their efficacy:
- Expand EMT workforce – Address shortages in rural and low-ranking states.
- Improve ER efficiency – Reduce wait times through better triage systems.
- Invest in infrastructure – Increase ambulance coverage and hospital accessibility.
- Enhance technology – Telemedicine and mobile emergency units could help improve response times.
Full Report & Methodology
These rankings are based on ambulance station density, hospital access, EMT availability, and ER wait times, using government-sourced data. For more details, visit Your Doctors Online.
Stay informed and prepared—because in an emergency, every second counts.
🤔Nurses, how does emergency care look in your state? Have you seen long ER wait times or ambulance delays? Share your experience in the discussion forum below!
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