title: Cost-effectiveness of childhood immunization reminder/recall systems in urban private practices.
abstract: OBJECTIVE
  To assess cost and cost-effectiveness of immunization reminder/recall systems in the private sector.
  
  
  METHODS
  A manual postcard system (mail) was compared with a computer-based telephone system (autodialer) and control. Costs included time costs and the cost of equipment and supplies. The cost per child and the incremental cost of the intervention relative to control were computed. Cost-effectiveness ratios were computed for return visits and for immunizations delivered.
  
  
  RESULTS
  The average cost per child was $2.28 for the mail group and $1.47 for the autodialer group. The incremental visit cost relative to the control was higher for the mail group ($9.52) than for the autodialer group ($3.48). The autodialer was more cost-effective in delivering immunizations: $4. 06 per extra immunization (autodialer) versus $12.82 (mail).
  
  
  CONCLUSIONS
  Excluding start-up costs, the autodialer system was most cost-effective. Including autodialer equipment costs, the autodialer system is more cost-effective only for larger practices.
authors.affiliation: University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
authors.forename: L
authors.initials: L
authors.lastname: Franzini
authors.forename: J
authors.initials: J
authors.lastname: Rosenthal
authors.forename: W
authors.initials: W
authors.lastname: Spears
authors.forename: H S
authors.initials: HS
authors.lastname: Martin
authors.forename: L
authors.initials: L
authors.lastname: Balderas
authors.forename: M
authors.initials: M
authors.lastname: Brown
authors.forename: G
authors.initials: G
authors.lastname: Milne
authors.forename: J
authors.initials: J
authors.lastname: Drutz
authors.forename: D
authors.initials: D
authors.lastname: Evans
authors.forename: C
authors.initials: C
authors.lastname: Kozinetz
authors.forename: B
authors.initials: B
authors.lastname: Oettgen
authors.forename: C
authors.initials: C
authors.lastname: Hanson
mesh_terms: D003362:Cost-Benefit Analysis; D006801:Humans; D007114:Immunization / Q000191:economics*; D007223:Infant; D011177:Postal Service; D011331:Private Practice / Q000191:economics*; D017010:Reminder Systems / Q000191:economics*; D013689:Telephone; D014504:Urban Health