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


METHODS
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.


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


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


RESULTS
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.
Fontanesi
John M
JM
Department of Pediatrics, University of California, San Diego, La Jolla 92093-0927, USA.
Flesher
Don S
DS
De Guire
Michelle
M
Lieberthal
Allan
A
Holcomb
Kathy
K
D002140:California; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003625:Data Collection; D003628:Database Management Systems / Q000191:economics*; D001330:Electronic Data Processing / Q000191:economics*; D006801:Humans; D017589:Immunization Programs / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data*; D011159:Population Surveillance; D040442:Public Health Informatics / Q000191:economics*; D012042:Registries; D013685:Telecommunications / Q000191:economics