The cost of doing business: cost structure of electronic immunization registries

Health Serv Res. 2002 Oct;37(5):1291-307. doi: 10.1111/1475-6773.10772.


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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • California
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Data Collection
  • Database Management Systems / economics*
  • Electronic Data Processing / economics*
  • Humans
  • Immunization Programs / economics
  • Immunization Programs / organization & administration
  • Immunization Programs / statistics & numerical data*
  • Population Surveillance
  • Public Health Informatics / economics*
  • Registries*
  • Telecommunications / economics