Health Serv Res. 2002 Oct;37(5):1291-307.

The cost of doing business: cost structure of electronic immunization registries.

Fontanesi JM¹, Flesher DS Jr, De Guire M, Lieberthal A, Holcomb K.

Author information

1: Department of Pediatrics, University of California, San Diego, La Jolla 92093-0927, USA.

Abstract

OBJECTIVE:

To predict the true cost of developing and maintaining an electronic immunization registry, and to set the framework for developing future cost-effective and cost-benefit analysis.

DATA SOURCES/STUDY SETTING:

Primary data collected at three immunization registries located in California, accounting for 90 percent of all immunization records in registries in the state during the study period.

STUDY DESIGN:

A parametric cost analysis compared registry development and maintenance expenditures to registry performance requirements.

DATA COLLECTION/EXTRACTION METHODS:

Data were collected at each registry through interviews, reviews of expenditure records, technical accomplishments development schedules, and immunization coverage rates.

PRINCIPAL FINDINGS:

The cost of building immunization registries is predictable and independent of the hardware/software combination employed. The effort requires four man-years of technical effort or approximately $250,000 in 1998 dollars. Costs for maintaining a registry were approximately $5,100 per end user per three-year period.

CONCLUSIONS:

There is a predictable cost structure for both developing and maintaining immunization registries. The cost structure can be used as a framework for examining the cost-effectiveness and cost-benefits of registries. The greatest factor effecting improvement in coverage rates was ongoing, user-based administrative investment.