A record 770,089 people presented to emergency departments between January and March this year, but 63,282 left without being discharged amid long post-pandemic wait times, a quarterly report from the Bureau of Health Information shows.
The figure is a slight improvement on the record number of walkouts between April and June 2022, when more than 76,000 patients left emergency without completing their treatment.
But the figures remain above pre-COVID-19 pandemic levels.
"While there was gradual improvement again on the time patients waited to start their treatment, they continued to wait longer and spend longer in the (emergency department) than before the pandemic," bureau chief executive Diane Watson said on Wednesday.
Almost 350,000 ambulance call-outs were made during the first three months of the year, the highest number since reporting began in 2010, with response times improving after getting worse last year.
An increasing demand for ambulances and emergency services began before the pandemic and showed no sign of slowing, the report found.
There were 10,868 of the highest-priority ambulance responses for patients with life-threatening conditions, up 16.1 per cent from the same time last year.
Signs showed the performance of the NSW health system was beginning to recover after the impacts of the pandemic, Health Minister Ryan Park said on Wednesday.
"That's a testament to the hard work and dedication of each and every one of our essential healthcare workers," he told AAP.
"But the health system is facing unprecedented demand and has suffered from a lack of investment in its frontline workforce."
About two-thirds of the highest-priority cases were reached within 10 minutes, an improvement from 2022.
Some 44 per cent of priority-one cases were reached by an ambulance within 15 minutes, up from a record low last year.
In general, ambulance patients were still waiting longer than before the pandemic, the report noted.
A separate survey by the bureau last year found patients were overwhelmingly satisfied with the care being given by the state's paramedics despite increased call-out numbers.
The report showed one in five ambulance patients arriving at hospital were still waiting too long to be transferred into care, president of the Australian Paramedics Association NSW Chris Kastelan said.
"These sobering numbers once again highlight that we desperately need action on the recommendations that came from the inquiry into ramping," Mr Kastelan said.
The inquiry made 12 recommendations in December, including that all hospitals experiencing bed block build dedicated weather-proof facilities out of the elements, and the government works to reduce hospital occupancy to 85 per cent over time.
The report would give the state government direction on how where to direct funding to build the strength of the health system, president of the AMA NSW Michael Bonning said.
"There is pressure on hospitals. There is pressure on ambulance services. There is pressure on public health services," Dr Bonning said.
"We need to properly fund and resource all parts of the health system – and we must keep them connected."
