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PEDIATRICS Vol. 106 No. 1 Supplement July 2000, pp. 177-183

Cost-Effectiveness of Childhood Immunization Reminder/Recall Systems in Urban Private Practices

Received Dec 28, 1999; accepted Apr 13, 2000.

Luisa Franzini*, Jorge RosenthalDagger , William Spears*, Heather S. Martin§, Lorena Balderas§, Martha Brown§, Gillian Milne§, Jan Drutz§, parallel , Donna Evans§, Claudia Kozinetz§, parallel , Barbara Oettgen, and Celine Hanson§, parallel

From the * University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Dagger  Centers for Disease Control and Prevention, National Immunization Program, Atlanta, Georgia; § Texas Children's Hospital, Houston, Texas; parallel  Baylor College of Medicine, Houston, Texas; and  North End Medical Center, St Paul, Minnesota.

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.  Key words:  cost, cost-effectiveness, reminder/recall systems, infant, immunizations.


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