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Terry Hastings/All Kids Count

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IMMUNIZATION REGISTRIES SAVE MORE THAN THEY COST

Atlanta, GA, September 20, 2000 - The costs of a nationwide system of state- and community-based immunization registries are considerably less than the cost offsets that such a system would produce, according to a new study. Such a system would cost an average of $3.91 per child per year, for all children aged 0 to 5, or $78 million annually, but it would “save” almost $114 million annually.

The study of immunization registry costs and cost offsets compared the projected annual cost for operating a nationwide system of registries with estimates of the cost to manually retrieve records for health and education purposes, the cost of over immunization, and the cost to conduct national coverage surveys. The study by researchers of All Kids Count, a program of the Robert Wood Johnson Foundation, appeared in the August issue of The American Journal of Preventive Medicine.

Currently, immunization registries – confidential, computerized state or community-based information systems – are operational or under development in all 50 states to assist in managing the growing complexity and volume of immunization information. By consolidating scattered records from multiple providers, registries can automatically provide accurate coverage rates for providers and populations, and can prevent unnecessary (duplicative) immunizations. They can also exchange information with other registries, which will assist parents in obtaining their child’s immunization history when they move to a new geographic location.

Although these systems are increasingly viewed as an essential tool for sustaining immunization rates, information about their cost-effectiveness and the resources needed to sustain these systems has been lacking.

Immunization registry costs

The study’s authors gathered cost data from 16 All Kids Count projects, which comprised some of the most developed immunization registries in the United States. They included nine state registries, two single-county registries, two multi-county registries, and three large urban city registries. The 16 registries represented approximately 19% of the nation’s birth cohort. Information was collected on costs to maintain a registry once it was “fully operational,” e.g., containing information on all children, all immunizations and all providers of immunizations.

Costs to maintain a nationwide network of registries once fully operational were compared with costs that would be offset by having a registry. These include eliminating costs for manually pulling immunization records for every child for school entry, child care or camp (estimated at least once in the first five years of life) and for a child to change health care providers (an estimated 22% of children in the first two years of life). Other costs that would be eliminated include duplicative immunizations (an estimated 21% of 19 to 35-month olds); costs for health plans to review immunization charts for HEDIS (Health Employer Data Information Set) reports (an estimated 67% of records); and a percentage of the cost of the National Immunization Survey, conducted annually by the Centers for Disease Control and Prevention. 

When added together these cost offsets total $113.8 million annually – substantially more than the annual estimated cost of $78.2 million annually for immunization registries. The study’s authors note that a further major cost offset would be produced by eliminating costs for schools to manually retrieve immunization records on all children entering school, childcare or Head Start programs.

They also note that the study considers immunization registries in isolation rather than as an integral part of a comprehensive patient information system, and that costs attributable to immunizations in such a system would be considerably lower. 

All Kids Count is a program of the Task Force for Child Survival and Development, based in Atlanta, GA. The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation’s largest philanthropy devoted exclusively to health and health care.