More than 79,000 patients left NSW emergency departments before completing treatment in the last quarter of 2025, an increase of nearly 11,000 from the same time in 2024, the Bureau of Health Information said.
There were also the highest number of overall emergency presentations, 820,009, for any quarter since 2010.
The increase was especially pronounced among those with the most urgent clinical conditions.
Doctors are particularly concerned about the numbers of patients with conditions not able to be treated anywhere else leaving emergency, with the peak body saying more than 27,000 had left in three months.
"Yet again, we have a system in crisis," president of the NSW branch of the Australian Medical Association Kathryn Austin said.
"We are not seeing any tangible plans from the NSW government to deal with the rising tide of patients needing hospital care for increasing complex issues."
The proportion of emergency patients being treated on time increased compared to three years ago, NSW Health Minister Ryan Park said.
Mr Park said overdue surgery numbers were reducing but a significant cause of backlog in NSW hospitals was bed block, patients waiting for aged care or NDIS placements.
States and territories struck a deal in January with the federal government to receive $25 billion extra in commonwealth funding.
"We're focused on saving our EDs for the patients who need it most while sparing people who don't require emergency care an unnecessary wait," Mr Park said.
His federal counterpart Mark Butler said it was now up to the states to decide how the extra funding would help them deliver on promises to provide better health services.
"We have more than halved the average number of days it takes to discharge an NDIS participant from hospital when they are medically ready," Mr Butler said.
The Bureau of Health Information statistics show the average length of NSW hospital stay for non-acute episodes was 19.3 days, the highest of any comparable quarter.
South Australia established a transition care service at the Adelaide Pullman Hotel last year to care for elderly patients who don't need hospital treatment but can't access federal aged care.
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