A new report by Ontario's auditor general finds that the province's hospital emergency rooms aren't meeting targets for wait times despite $200 million in extra funding over the past two years.

In the report released Monday, Jim McCarter said that ER woes are linked to problems elsewhere in the hospital system.

Because care couldn't be arranged for hospital patients awaiting discharge, more than 50,000 patients were kept in hospital longer than necessary, he said.

“When there are no beds for new admissions, patients have to wait in emergency rooms, and that causes overcrowding and delays," McCarter said.

Emergency patients who required hospital admission waited an average of 10 hours for a bed, with some waiting up to 26 hours, he found.

Wait times for patients with serious conditions had reached 12 hours or more. The province’s target is eight hours.

"Guidelines used in Ontario emergency departments recommend that patients be triaged within 10 to 15 minutes of arrival, but some patients waited for more than an hour," McCarter said.

Some hospitals have limited resources with respects to on-site specialists and diagnostic services. This is hurting their ability to treat emergency patients quickly, he said.

Another problem is finding nurses, especially to work on nights, weekends and holidays, the watchdog said.

McCarter said one nurse earned $157,000 in 2009, with $90,000 coming in overtime pay, he said.

Home care

The report found that home-care service can vary widely by location across the province.

Only three of the province's 14 Community Care Access Centres had no waiting lists. The other 11 had 10,000 people on waiting lists, with an average wait time of eight days -- and the longest being 262 days.

Some patients had waited up to 15 months just for an assessment, he said.

About 50 per cent of patients who could have been discharged from hospital -- had home-care been available to them -- spent an average of six extra days in hospital each as they waited for such care, he said.

Part of the problem is that the Ministry of Health and Long-term Care is allocating funding based on what it paid in the past, rather than by the "specific needs of the local clientele," McCarter wrote.

Given its aging population, Ontario faces more strains on its system in the coming years, he said.

"In 2009, people aged 65 or over accounted for just 13% of Ontario’s population but almost 60% of patient-days in hospital," McCarter wrote.

"In the next 20 years, the number of seniors is expected to double, making the need for efficient discharge proce¬dures all the more critical."