Background: Although the value of point-of-care ultrasound (PoCUS) is well-established for specific diseases and in the hands of trained users, its broader impact on overall ED efficiency is not yet fully known. This study aims to evaluate the association of early PoCUS, performed within 1 h of presentation, with ED patient flow, healthcare resource utilization, and quality of care in adults with non-traumatic abdominal pain. Method: This retrospective cohort study included 44,863 adult patients (≥18 years) presenting with non-traumatic abdominal pain from January 2021 to December 2023. Patients were grouped into PoCUS and no-PoCUS categories, with a subgroup analysis for those receiving PoCUS within 1 h, to evaluate ED LOS, and costs for different ED dispositions. Outcomes measured included hospital LOS, costs, mortality, and ICU admission. Results: The mean age of the subjects was 44.4 ± 17.9 years, and 61.2% were female. PoCUS was performed in 39.7% of cases, with 69.6% of these conducted within one hour. Additionally, 30.5% underwent CT. The PoCUS group had a significantly shorter ED LOS compared to the no-PoCUS group among patients admitted to general wards (p < 0.001), but not in outpatient dispositions (p = 0.282) or ICU admissions (p = 0.081). Subgroup analysis of patients receiving PoCUS within 1 h showed a significantly shorter LOS for both outpatient dispositions (p < 0.001) and general ward admissions (p < 0.001), with no effect on ICU admissions (p = 0.869). The presence or absence of CT did not alter these findings. Multivariable analysis indicated that patients who received PoCUS within one hour alone at index visit and admitted after an unscheduled return visit had lower initial ED costs (−9436.1 TWD, p < 0.001) and shorter ED LOS (−11.59 min, p < 0.001) than patients admitted directly at the index visit, with no significant increase in total resource utilization or adverse outcomes after return visits. Conclusions: PoCUS, especially when performed within one hour, was associated with reduced ED LOS and healthcare resource utilization for both outpatient dispositions and inpatient admissions without compromising patient safety or quality of care.

Background: To evaluate the association of point-of-care ultrasound (PoCUS) performed within one hour of emergency department (ED) arrival with ED length of stay (LOS) and healthcare costs in admitted ED patients with non-traumatic abdominal pain. Methods: This retrospective, inverse probability of treatment weighting (IPTW) cohort study was conducted at a tertiary medical center in Taiwan. This study analyzed data from 2021–2023, focusing on adult patients admitted to an ordinary ward with non-traumatic abdominal pain. Patients discharged from the ED, admitted to the ICU, or receiving PoCUS > 1 h (N = 864) were excluded. The final cohort of 6866 patients comprised those receiving PoCUS within 1 h (N = 1542) and those receiving no PoCUS (N = 5324). Primary and secondary outcomes (ED LOS, costs) were adjusted for age, gender, triage, vital signs, BMI, and comorbidities using generalized linear models with a Gamma distribution. Results: After IPTW adjustment in 6866 admitted abdominal pain patients, PoCUS within one hour was associated with a 14% shorter ED LOS (RM 0.86, 95% CI 0.83–0.89). A notable finding was that PoCUS performed within one hour was associated with 44% higher odds of CT utilization (OR 1.44, 95% CI 1.25–1.65) and 5% lower total healthcare costs (RM 0.95, 95% CI 0.91–0.99). Stratification by CT use revealed distinct patterns underlying these associations: in the non-CT subgroup, PoCUS was associated with 12% lower ED costs (RM 0.88, 95% CI 0.83–0.94), whereas in the CT subgroup, it was associated with 9% lower admission costs (RM 0.91, 95% CI 0.86–0.96). Conclusions: In admitted patients, PoCUS performed within one hour was associated with shorter ED LOS and lower total costs, despite a concurrent association with higher CT utilization. These findings are consistent with a dual, context-dependent role for PoCUS: associated with reduced ED costs in non-CT pathways and lower admission costs in CT pathways. However, as this is an observational study, these results represent associations rather than causal effects and may be influenced by unmeasured confounding. Prospective trials are required to validate these findings.