Association between point-of-care ultrasonography use and requests for formal imaging studies in hospital-based internal medicine: A retrospective cohort study.

BACKGROUND: Point-of-care ultrasonography (POCUS) has expanded rapidly among hospitalists. However, its impact on the use of additional formal investigations and healthcare costs remains unclear. This study aimed to describe the evolution of POCUS use within a university hospital general internal medicine department and assess its association with requests for formal radiological and cardiological investigations. METHODS: We conducted a retrospective observational study including all POCUS exams archived in the hospital's picture archiving system performed by hospital-based internists at the Geneva University Hospitals (Geneva, Switzerland) between January 2020 and December 2025. The association between POCUS use and the number of formal radiological and cardiological investigations requested was assessed through a multivariable linear regression. RESULTS: During the study period, the annual number of POCUS exams increased substantially, with a 402.5% rise between 2020 and 2025. Lung ultrasonography was the most frequently performed exam (44%), followed by focused echocardiography (36%) and abdominal or vascular ultrasonography (20%). The increase in POCUS activity was associated with a parallel reduction in radiological ultrasonography and echocardiography. This result, while significant, was modest. After adjustment for the number of hospitalizations and CT scan requests, POCUS use was independently associated with decreased reliance on radiological ultrasonography (β = -0.10, 95% CI -0.15 to -0.05, p < .001). CONCLUSIONS: The use of POCUS in internal medicine has steadily increased over the past 5 years and appears to provide significant diagnostic value. Its growing adoption may contribute to reduced reliance on additional formal investigations, with potential implications for healthcare cost containment.