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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.


DATA SOURCES/STUDY SETTING
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.


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


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


PRINCIPAL FINDINGS
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.