ER Wait Times in North Carolina (2025)

Emergency room (ER) wait times in North Carolina have become a significant issue affecting the quality of healthcare and the efficiency of hospital systems across the state. While the problem has been growing in recent years, it has been exacerbated by a combination of demographic shifts, increased demand for services, and workforce shortages. As patients find themselves waiting longer for care, policymakers, healthcare administrators, and medical professionals are all grappling with how to address the issue effectively.

North Carolina Hospitals with Shortest Wait Times

Below are five hospitals in North Carolina with the shortest emergency room wait times:

  • 🥉  Highlands Cashiers Hospital, with an average wait time of 1.6 hours, ranks third for the shortest ER wait time in North Carolina
  • Atrium Health Anson, with an average wait time of 2.0 hours, ranks fourth for the shortest ER wait time in North Carolina
  • Dosher Memorial Hospital, with an average wait time of 2.0 hours, ranks fifth for the shortest ER wait time in North Carolina

North Carolina Hospitals with Longest Wait Times

Below are five hospitals in North Carolina with the longest emergency room wait times:

  • 🐢  Duke Regional Hospital, with an average wait time of 5.2 hours, ranks second for the longest ER wait time in North Carolina
  • 🦥  ECU Health Medical Center, with an average wait time of 4.9 hours, ranks third for the longest ER wait time in North Carolina
  • UNC Hospitals, with an average wait time of 4.4 hours, ranks fifth for the longest ER wait time in North Carolina

Growing Demand for Emergency Services

North Carolina, like many other states, has witnessed a steady increase in its population over the past decade. According to the U.S. Census Bureau, the state’s population has grown by nearly 10% since 2010, placing additional pressure on its healthcare infrastructure. While population growth is a key driver of this demand, it is the state’s rapidly aging population that plays the most significant role in driving up ER wait times.

Older adults, especially those over the age of 65, are among the most frequent users of emergency departments. Chronic conditions such as heart disease, diabetes, and respiratory disorders, which are more common in older adults, require ongoing medical attention. As North Carolina’s aging population continues to increase, the demand for emergency care will likely intensify. According to the North Carolina Department of Health and Human Services (NCDHHS), people aged 65 and older account for a disproportionate share of ER visits. This demographic shift, coupled with the rise in chronic illnesses, further strains emergency departments already grappling with increasing patient loads.

Underlying Causes of Longer Wait Times

Beyond demographic trends, there are several systemic factors contributing to longer ER wait times in North Carolina. One significant cause is the lack of access to primary care, particularly in rural areas. For many patients, the emergency room is the only viable option for medical care when they cannot access a primary care provider. This is especially true in rural and underserved areas, where healthcare facilities are limited, and physicians are scarce. The shortage of primary care providers, combined with the difficulty of securing timely appointments, pushes more patients into emergency departments.

This phenomenon, often referred to as “non-urgent” ER visits, accounts for a substantial portion of emergency department traffic. According to a study conducted by the North Carolina Institute of Medicine, nearly 40% of ER visits in the state are for non-urgent conditions that could be managed in primary care settings. As a result, hospitals are increasingly forced to balance urgent cases with patients seeking care for less severe issues, thereby extending wait times for all patients.

Impact of Workforce Shortages

Perhaps one of the most pressing issues contributing to longer wait times in North Carolina’s emergency rooms is the ongoing shortage of healthcare professionals, particularly emergency medical staff. According to a report by the North Carolina Medical Society, the state faces a significant shortage of emergency room physicians and nurses, which has only worsened in recent years.

North Carolina’s hospitals are struggling to recruit and retain skilled healthcare professionals. While the state’s medical schools produce a steady stream of new graduates, many choose to practice in more urban areas where salaries tend to be higher and the quality of life is better. Rural hospitals, in particular, have been disproportionately affected by this shortage. As a result, emergency departments often rely on temporary staffing solutions, such as locum tenens physicians and travel nurses, which can provide short-term relief but do little to solve the root cause of the issue.

Staffing shortages not only lead to longer wait times but also contribute to physician and nurse burnout. The intense pressure of working in understaffed emergency departments can lead to reduced job satisfaction, and ultimately, higher turnover rates. This cycle perpetuates the staffing shortage, making it even more difficult for hospitals to keep up with the growing demand for emergency care.

The COVID-19 Aftermath

The COVID-19 pandemic placed unprecedented strain on North Carolina’s healthcare system. During the height of the pandemic, emergency departments were overwhelmed with patients, and many hospitals deferred non-urgent care to make room for COVID patients. While the acute phase of the pandemic has passed, its effects continue to reverberate across the state.

First, the backlog of deferred medical care—elective surgeries, routine checkups, and chronic condition management—has led to an increased number of patients seeking emergency care for conditions that could have been managed earlier. This backlog of untreated or poorly managed conditions has intensified the demand on ERs, leading to even longer wait times.

Second, many patients are still dealing with long-term effects from the virus. Post-COVID complications, including respiratory issues, cardiovascular problems, and neurological symptoms, have become common reasons for emergency room visits. As a result, hospitals continue to face the dual challenge of handling COVID-related emergencies and maintaining capacity for non-COVID-related cases, further stretching already thin resources.

Technological Innovations and Process Improvements

In response to the rising demand for emergency care, hospitals in North Carolina are exploring technological solutions to improve the efficiency of their emergency departments. One of the most promising developments is the use of predictive analytics to forecast peak demand and optimize staffing levels. Hospitals are leveraging data to anticipate busy periods and allocate resources accordingly, improving the overall flow of patients through the ER.

For example, several hospitals in the state have implemented real-time patient tracking systems, which allow staff to monitor patient status and optimize care delivery. These systems help hospitals identify bottlenecks in patient flow, whether they are related to staffing issues or resource shortages, and make adjustments in real-time.

Telemedicine has also emerged as an important tool in managing ER wait times. By offering virtual consultations for non-urgent cases, hospitals can reduce the number of patients physically visiting the ER, allowing staff to focus on more critical cases. While telemedicine has been used sparingly in emergency departments, it holds great potential in reducing unnecessary visits and ensuring that resources are reserved for those who need them most.

Additionally, some hospitals are experimenting with triage protocols that better distinguish between urgent and non-urgent cases. By more effectively categorizing patients, hospitals can allocate resources in a way that ensures patients with the most critical needs are treated first. This is especially important as the volume of patients continues to rise, and ERs are forced to make difficult decisions about care priorities.

Policy Solutions and Workforce Initiatives

While technology offers promising solutions, addressing the root causes of ER wait times in North Carolina will also require policy intervention and a focus on workforce development. Expanding access to primary care services, particularly in underserved rural areas, is a critical piece of the puzzle. Policymakers must continue to explore ways to incentivize primary care providers to practice in rural areas, such as offering loan repayment programs, higher reimbursements, and other financial incentives.

Additionally, efforts to expand Medicaid and improve insurance coverage could help reduce the number of patients who rely on emergency rooms for primary care. By ensuring that more people have access to timely, affordable care, North Carolina can alleviate some of the pressure on its emergency departments.

Investing in the healthcare workforce is equally essential. North Carolina must address the underlying causes of the shortage of emergency care providers, including physician burnout, the high cost of medical education, and the uneven distribution of healthcare professionals across urban and rural areas. Strengthening medical training programs and providing incentives for healthcare workers to practice in underserved areas could help build a more sustainable healthcare workforce, ultimately reducing wait times in emergency departments.

Better Emergency Care for North Carolina

As the demand for emergency care continues to grow in North Carolina, addressing ER wait times will require a multifaceted approach. Hospitals must embrace technological innovations that improve patient flow and optimize staffing. Policymakers must expand access to primary care and invest in workforce development to ensure that emergency departments can meet the growing demand for care. While progress is being made, it will take concerted effort from healthcare providers, lawmakers, and communities to resolve the issue of ER wait times and ensure that North Carolina’s healthcare system can meet the needs of its patients in the years to come.

In the end, reducing ER wait times is not just about improving efficiency—it’s about ensuring that patients receive the timely care they need, when they need it most. Addressing this issue is critical not only for improving patient outcomes but also for sustaining the long-term health of North Carolina’s healthcare system.

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