Background: In 1993, the Boston Immunization Information System (BIIS) was introduced as an electronic registry, tracking, and recall system. BIIS is used in community health centers, hospitals and private practices.
Objectives: Quantify costs of developing and maintaining BIIS in 1998; measure annual cost/child; identify savings accrued from using BIIS; evaluate outcome measures (immunization and overimmmunization rates), explore cost-effectiveness.
Methods: Data on building and using costs collected at 23 BIIS sites, control sites and the health department. Cost and immunization rate data from experimental and control sites obtained for 1993-4 and 1997-8 (pre- and post-BIIS). Data sources: fiscal document reviews, personnel interviews, time and motion information. Projected costs of an expanded hypothetical registry were also calculated.
Results: Total annual cost in 1998 was $345,556 (annual cost/child $5.45). Compared to control sites, cost savings varied by function with greatest savings related to immunization report generation ($167, 394) and tracking ($32,360). BIIS saved $44,048 in 1998 compared to carrying out similar functions without a registry. Immunization coverage levels increased at both BIIS and control sites, with no significant differences in the groups (F=1.47, p=0.23). Overimmunization rates were low for MMR (0.78%) and DTP (1.2%); 15% for OPV. Total annual cost of a hypothetical expanded citywide registry in 1999 was $577,920, with estimated savings of $716,843 compared to a non-registry system.
Conclusions: Immunization registries are an important tool to accomplish critical clinical and public health activities, and can be cost-effective. Novel ways to further decrease building costs, which account for the majoriy of registry cost, should be explored.
Learning Objectives: At the end of the session, participants will be able to: 1) identify the cost of building and using an urban immunization registry, and 2) evaluate the effect of registry expansion on costs and savings
Keywords: Immunizations, Registry
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.