Researchers from the University of California at San Diego, writing in
the January issue of the American Journal of Preventive Medicine, calculate
that $0.013 per child per month is needed to make recommended innovations
such as patient education and feedback to doctors a regular part of immunization
practice.
“Public health officials, policymakers, insurers and healthcare
entities must make difficult decisions about which programs to support
or implement. Understanding cost and quality improvement is a critical
component of this decision-making process,” John Fontanesi, Ph.D.,
and colleagues say.
Auditing and feedback systems and related software were
the most expensive part of the recommended upgrades, the researchers
found. But they said
costs ran high in clinics where children’s immunization records
were not available electronically, leading to laborious searches through
paper
files for audit data.
It is unclear whether a clinic’s funding for immunizations is enough
to cover the current cost, Fontanesi says, adding that “it is unlikely
to cover the costs of practice improvement.”
Until new funding opportunities are made available, “this essential
preventive service will continue to rely on the good intentions and financial
resources of the facilities providing the service,” he adds.
The researchers calculated improvement costs using data from 15 clinics
in San Diego County that primarily serve patients at risk for low immunization
coverage. The clinics included hospitals, private practices and community
clinics.
Some of the clinics chose to implement the immunization
recommendations throughout their system, while others emphasized making
the changes
at the level of individual doctors. The costs were “remarkably constant” in
each case but the changes were more lasting when implemented throughout
the entire system, Fontanesi and colleagues concluded.
