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American Academy of Pediatrics
Article

The Cost of Giving Childhood Vaccinations: Differences Among Provider Types

Judith E. Glazner, Brenda L. Beaty, Kellyn A. Pearson and Stephen Berman
Pediatrics June 2004, 113 (6) 1582-1587; DOI: https://doi.org/10.1542/peds.113.6.1582
Judith E. Glazner
*Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, Colorado
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Brenda L. Beaty
‡Colorado Health Outcomes Center, University of Colorado Health Sciences Center, Denver, Colorado
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Kellyn A. Pearson
§Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado
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Stephen Berman
§Department of Pediatrics, University of Colorado Health Sciences Center, Denver, Colorado
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Abstract

Objective. To describe costs to providers of delivering childhood immunizations.

Methods. We collected variable costs—costs that vary with the amount of services rendered—including cost of practitioner and staff time and supplies, using a cost accounting method, from 12 practices (4 pediatric practices, 4 family practices, and 4 public health agencies) in rural and urban areas in Colorado. For private practices, we estimated fixed costs—costs that do not vary with the amount of services, eg, rent and insurance). We also collected reimbursement information for vaccinations for private practices.

Results. Variable costs per shot (excluding vaccine cost) were $8.15 for pediatric practices, $5.79 for family practices, and $5.41 for public health agencies. Total costs per shot, including fixed costs, were $10.67 for pediatric practices and $7.57 for family practices. Average reimbursement for pediatricians and private family practices was $8.27 and $6.68, respectively. For pediatric practices, average variable costs were barely exceeded by average reimbursement, and reimbursement was 22% less than average total costs. This contrasts with an earlier study of the rural practices investigated here, in which there was a comfortable margin between reimbursement and variable costs.

Conclusion. The decline in the ratio of reimbursement to cost for private practices, particularly for pediatric practices, suggests that referral to public agencies by private providers for vaccinations may increase and that if vaccinations are not as frequently provided in the child's medical home, then the currently high childhood immunization rates may be in jeopardy.

  • childhood immunization
  • vaccination
  • cost analysis
  • immunization cost
  • immunization reimbursement
  • Received August 5, 2003.
  • Accepted October 15, 2003.
  • Copyright © 2004 by the American Academy of Pediatrics

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Pediatrics
Vol. 113, Issue 6
1 Jun 2004
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The Cost of Giving Childhood Vaccinations: Differences Among Provider Types
Judith E. Glazner, Brenda L. Beaty, Kellyn A. Pearson, Stephen Berman
Pediatrics Jun 2004, 113 (6) 1582-1587; DOI: 10.1542/peds.113.6.1582

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The Cost of Giving Childhood Vaccinations: Differences Among Provider Types
Judith E. Glazner, Brenda L. Beaty, Kellyn A. Pearson, Stephen Berman
Pediatrics Jun 2004, 113 (6) 1582-1587; DOI: 10.1542/peds.113.6.1582
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Subjects

  • Infectious Disease
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Keywords

  • childhood immunization
  • vaccination
  • cost analysis
  • immunization cost
  • immunization reimbursement
  • CHC, community health center
  • CRISP, Colorado Rural Immunization Services Project
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