A growing and ageing Queensland population has put pressure on the state's hospitals and ambulances over a five year period.
An auditor-general report has found 16 public hospitals and the state's health department had increased demand across a number of services.
Ambulances lost 160,028 hours for patients who waited more than 30 minutes on a Queensland Ambulance Service stretcher, while long waits for special outpatient services increased by eight per cent.
The number of presentations across Queensland's top 26 hospitals increased by one per cent with overall growth over five years at 11 per cent, the report by Auditor-General Brendan Worrall found.
Demand was felt the most in Cairns, Sunshine Coast, Darling Downs, Townsville and Metro North hospital and health services in that period.
"The Queensland Ambulance Service continues to face growing demand for all its services, including the most urgent ones," Mr Worrall said.
"The time it takes ambulance crews to transfer patients into the care of emergency departments continues to be well below target.
There were more ambulance presentations across the top 26 hospitals than walk-in presentations, with all emergency department presentations increasing faster than population growth.
The report found an increase in demand for ambulance emergency cases was driven by population growth and changes in demographics.
Queensland ranked third in the nation behind WA and NSW in 2021-22 for emergency department presentations with a length of stay of less than four hours or less.
Despite a 33 per cent growth in code 1 emergency incidents over a five-year period, the QAS achieved better response times than most other jurisdictions.
But in 2022–23, the QAS did not meet its response time performance targets for code 1 calls and has not met its response time targets for the most urgent category of calls since 2020–21.
The report also found expenditure increases across health services increased by 9.4 per cent from $18.1 billion to $19.8 billion.
Growth in employee expenses was up 11.3 per cent with variances between 1.7 per cent and 12.8 per cent.
That was partly attributed to a nearly three per cent increase in the number of full time equivalent staff in Queensland Health.
Mr Worrall's key recommendations from the report point toward maintaining strong controls over employee expenses, with Queensland Health being the largest employer in the state with over 125,000 employees.
He said the department and 16 hospital and health services should reassess more effective and efficient ways to control overtime approvals and monitor unplanned and planned overtime.