Patients at U.S. hospitals are experiencing the longest wait times in emergency departments since reports were first made available in 2002, according to Press Ganey Associates Inc.

From the moment patients walk into a hospital ED until the time they are discharged from it, the average time spent is four hours and seven minutes in 2009, an increase of four minutes compared with 2008 and 31 minutes more than the nationwide average in 2002.

The data is based on evaluations of more than 1.5 million patients treated at 1,893 hospitals in 2009.

In terms of wait time, Utah had the worst performance, with an average ED wait of eight hours and 17 minutes—nearly an hour and a half longer than the state's average time spent last year.

Iowa had the shortest average time spent at just under three hours (2:55), followed by South Dakota (2:59), North Dakota (3:07), Nebraska (3:08) and Minnesota (3:11).

Despite longer wait times, patient satisfaction with U.S. hospital EDs stayed about the same in 2009, following a five-year upward trend. More than half the states were able to improve wait times or keep increases to a minimum.

The report found that communication is key to providing patients with satisfactory ED experiences. Patients are willing to wait for care as long as they are kept informed about wait times. Patients who waited more than four hours, but received "good" or "very good" information about delays were just as satisfied as patients who spent less than one hour in the ED. In fact, patient evaluation of communication about delays is identified as a key driver nationally of satisfaction.