The Bureau of Health Information's quarterly report from October to December 2018 shows Wagga Base Hospital saw significant increases in both arrivals at its emergency department by ambulance and in overall patient numbers.

Arrivals by ambulance were up almost 25 per cent from 2419 to 3019 and overall presentations up almost 12 per cent from 10,494 to 11,728 compared to the same period in 2017.

Despite this large increase in patients arriving at the emergency department, the percentage of patients leaving the ED within four hours of presentation increased from 70 to 71.8 per cent.

On the back of these figures, the NSW Nurses and Midwives’ Association has renewed calls for a one-to-three nurse-to-patient ratio in emergency departments.

General secretary of the association Brett Holmes said there was a clear need for a reliable nurse-to-patient ratios system that was guaranteed in law.

“Many regional hospitals continue to experience a higher volume of patients, yet under the current staffing model those patients receive less nursing hours compared to their city counterparts. It is unacceptable patients are disadvantaged simply for living outside of the city," he said.

Simon Judkins, the president of the Australasian College for Emergency Medicine, who visited Wagga Base Hospital on Friday, said there would always be increases in hospital admissions because of population growth.

"I think there is also an issue with accessibility to health care in other areas. Emergency departments are open 24 hours a day, seven days a week," he said.

"With mental health, for example, without access to care outside the nine-to-five cycle, a lot of people who find themselves in crisis will be brought to the emergency department.

"Emergency departments are getting busier and busier, so I think we need to look at continued growth of emergency physicians and certainly in regional and rural areas, we need to make a big investment in getting more trained physicians."

Dr Judkins said violence was also a big issue for hospital staff.

"We talk about the effects of drugs and alcohol and that's inter-linked, I think, with the long waits we see in some emergency departments," he said.

"Interestingly, I was talking to the staff here and they've done a fantastic job to reduce the long-stay waits for mental health patients in the emergency department."