Cost of universal influenza vaccination of children in pediatric practices.
OBJECTIVE
The goals were to estimate nationally representative pediatric practices' costs of providing influenza vaccination during the 2006-2007 season and to simulate the costs pediatric practices might incur when implementing universal influenza vaccination for US children aged 6 months to 18 years.


METHODS
We surveyed a stratified, random sample of New York State pediatric practices (N = 91) to obtain information from physicians and office managers about all practice resources associated with provision of influenza vaccination. We estimated vaccination costs for 2 practice sizes (small and large) and 3 geographic areas (urban, suburban, and rural). We adjusted these data to obtain national estimates of the total practice cost (in 2006 dollars) for providing 1 influenza vaccination to children aged 6 months to 18 years.


RESULTS
Among all respondents, the median total cost per vaccination was $28.62 (interquartile range: $18.67-45.28). The median component costs were as follows: clinical personnel labor costs, $2.01; nonclinical personnel labor costs, $7.96; all other (overhead) costs, $10.43. Vaccine purchase costs averaged $8.22. Smaller practices and urban practices had higher costs than larger or suburban practices. With the assumption of vaccine administration reimbursement for all Vaccines for Children (VFC)-eligible children at the current Medicaid median of $8.40, the financial loss across all US pediatric practices through delivery of VFC vaccines would be $98 million if one third of children received influenza vaccine.


CONCLUSIONS
The total cost for pediatric practices to provide influenza vaccination is high, varies according to practice characteristics, and exceeds the average VFC reimbursement.
Yoo
Byung-Kwang
BK
University of Rochester, School of Medicine and Dentistry, Division of Health Policy and Outcomes Research, Department of Community and Preventive Medicine, 601 Elmwood Ave, Box 644, Rochester, NY 14642, USA. byung-kwang_yoo@urmc.rochester.edu
Szilagyi
Peter G
PG
Schaffer
Stanley J
SJ
Humiston
Sharon G
SG
Rand
Cynthia M
CM
Albertin
Christina S
CS
Vincelli
Phyllis
P
Blumkin
Aaron K
AK
Shone
Laura P
LP
Coleman
Margaret S
MS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016527:Drug Costs / Q000706:statistics & numerical data; D005251:Fees, Medical / Q000706:statistics & numerical data; D017048:Health Care Costs / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007182:Income; D007223:Infant; D007252:Influenza Vaccines / Q000191:economics*; D032541:Mass Vaccination / Q000191:economics*; D008484:Medicaid / Q000191:economics; D009518:New York; D010372:Pediatrics / Q000191:economics*; D011216:Practice Management, Medical / Q000191:economics; D011331:Private Practice / Q000191:economics; D012051:Reimbursement Mechanisms / Q000191:economics; D017664:Uncompensated Care / Q000191:economics; D014481:United States
D007252:Influenza Vaccines