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A Cost-Effectiveness Analysis Model for Immunization Registries: The New Jersey Experience
A Cost-Effectiveness Analysis Model for Immunization Registries: The New Jersey Experience Hugh M . Pratt, PhD Barbara D. Goun, PhD Lory L. Alexander, MSN, MBA
Andrea A. Bolden, BA Orit Even-Shoshan, MA J. Sanford Schwartz, MD
The New Jersey Comprehensive Immunization Project (NJ-CIP) is a computerized immunization registry being established in the state of New Jersey. The Leonard Davis Institute of Health Economics at the University of Pennsylvania and the University of Medicine and Dentistry of New Jersey are collaborating on a cost-effectiveness analysis of the project. This article presents a Net Present Value methodology for aggregating and analyzing all economically quantifiable aspects of the NJ-CIP. Baseline data have been collected for the analysis of the project. However, full project analysis will not be possible until the expected collection of postintervention data. The full cost-effectiveness evaluation is expected to be completed by February 1, 1997. Cost-effectiveness will be assessed by comparing changes in immunization rates with the total economic impact of the NJ-CIP.
Changes in immunization coverage will be assessed using four different measures of immunization rates to provide insights into immunization coverage. The four immunization coverage measures are Lifetime Optimally Immunized (LOI), Adequately Immunized (AI), Percent of Life Undervaccinated (PLUV), and CASA Age Appropriate Immunization (CASA AAI). The article outlines potential benefits and costs associated with the project, such as increased immunization rates, reduced loss in parental income, and registry costs. The integration of this information into the cost-effectiveness analysis is also described. Medical Subject Headings (MeSH): child; child health services/ec; computer systems; cost-benefit analysis; costs and cost analysis; registries; immunization. [AmJ Prev Med 1997;13(Suppl1):l1S-9]
In today's environment of ever tighter budgets and heightened accountability for results, cost-effectiveness analysis has become a critical basis for motivating new medical products and procedures. This article covers the proposed cost-effectiveness study of the New Jersey Comprehensive Immunization Project (Nj-CIP), a computerized immunization registry and tracking system, which is being conducted by the Leonard Davis Institute of Health Economics at the University of ·Pennsylvania in collaboration with the University of Medicine and Dentistry of New Jersey. Details of the operations of the Nj-CIP are presented below.
The primary objective of our study is not to evaluate just the costs of the Nj-CIP, but its cost-effectiveness. To be costeffective, a project must return value for the investment in the project. To determine cost-effectiveness, our study will try to answer three questions: (1) what change in immunization rates will result from the net economic impact of the registry, (2) what is the change in cost of immunizing a child with the assistance of the registry, and (3) what is the total economic impact of the registry?
From the Leonard Davis Institute of H ea lth Economics, University of Pen nsylva nia, Philadelphia, Pennsylvan ia (Pratt, Alexa nder, Bolden, Even-Shoshan, Schwartz) and University of Medicine and Dentistry of New Jersey, New Brunswick, New J ersey (Goun ). Address reprint requests to Dr. Pratt, 34 73 Beechwood Boulevard, Pitts burgh, PA 1521 7-2942 (e-mail: hmpst4 + @pitt.edu). © 1997 American Journal of Preventive Medicine. Developing Immunization Registries: Experiences From the All Kids Count Program is a supplement to Volume 13, Number 2.
Theory of Cost-Effectiveness and Required Information The cost-effectiveness evaluation of the NJ-CIP combines the disciplines of economics, epidemiology, and medicine. In all economic situations, including those involving health care interventions, society faces limited resources, wants and needs exceed these resources, and decisions must be made concerning the allocation of resources; therefore, the objective of health economics is the assessment of the most efficient use of available resources, defined in terms of patient o utcome and cost. The four most important factors evaluated in health economics are safety (Are the side effects acceptable? ), efficacy (Can it work ?), effective-
Cost-Effective Model for Immunization Registries 115
Andrea A. Bolden, BA Orit Even-Shoshan, MA J. Sanford Schwartz, MD
The New Jersey Comprehensive Immunization Project (NJ-CIP) is a computerized immunization registry being established in the state of New Jersey. The Leonard Davis Institute of Health Economics at the University of Pennsylvania and the University of Medicine and Dentistry of New Jersey are collaborating on a cost-effectiveness analysis of the project. This article presents a Net Present Value methodology for aggregating and analyzing all economically quantifiable aspects of the NJ-CIP. Baseline data have been collected for the analysis of the project. However, full project analysis will not be possible until the expected collection of postintervention data. The full cost-effectiveness evaluation is expected to be completed by February 1, 1997. Cost-effectiveness will be assessed by comparing changes in immunization rates with the total economic impact of the NJ-CIP.
Changes in immunization coverage will be assessed using four different measures of immunization rates to provide insights into immunization coverage. The four immunization coverage measures are Lifetime Optimally Immunized (LOI), Adequately Immunized (AI), Percent of Life Undervaccinated (PLUV), and CASA Age Appropriate Immunization (CASA AAI). The article outlines potential benefits and costs associated with the project, such as increased immunization rates, reduced loss in parental income, and registry costs. The integration of this information into the cost-effectiveness analysis is also described. Medical Subject Headings (MeSH): child; child health services/ec; computer systems; cost-benefit analysis; costs and cost analysis; registries; immunization. [AmJ Prev Med 1997;13(Suppl1):l1S-9]
In today's environment of ever tighter budgets and heightened accountability for results, cost-effectiveness analysis has become a critical basis for motivating new medical products and procedures. This article covers the proposed cost-effectiveness study of the New Jersey Comprehensive Immunization Project (Nj-CIP), a computerized immunization registry and tracking system, which is being conducted by the Leonard Davis Institute of Health Economics at the University of ·Pennsylvania in collaboration with the University of Medicine and Dentistry of New Jersey. Details of the operations of the Nj-CIP are presented below.
The primary objective of our study is not to evaluate just the costs of the Nj-CIP, but its cost-effectiveness. To be costeffective, a project must return value for the investment in the project. To determine cost-effectiveness, our study will try to answer three questions: (1) what change in immunization rates will result from the net economic impact of the registry, (2) what is the change in cost of immunizing a child with the assistance of the registry, and (3) what is the total economic impact of the registry?
From the Leonard Davis Institute of H ea lth Economics, University of Pen nsylva nia, Philadelphia, Pennsylvan ia (Pratt, Alexa nder, Bolden, Even-Shoshan, Schwartz) and University of Medicine and Dentistry of New Jersey, New Brunswick, New J ersey (Goun ). Address reprint requests to Dr. Pratt, 34 73 Beechwood Boulevard, Pitts burgh, PA 1521 7-2942 (e-mail: hmpst4 + @pitt.edu). © 1997 American Journal of Preventive Medicine. Developing Immunization Registries: Experiences From the All Kids Count Program is a supplement to Volume 13, Number 2.
Theory of Cost-Effectiveness and Required Information The cost-effectiveness evaluation of the NJ-CIP combines the disciplines of economics, epidemiology, and medicine. In all economic situations, including those involving health care interventions, society faces limited resources, wants and needs exceed these resources, and decisions must be made concerning the allocation of resources; therefore, the objective of health economics is the assessment of the most efficient use of available resources, defined in terms of patient o utcome and cost. The four most important factors evaluated in health economics are safety (Are the side effects acceptable? ), efficacy (Can it work ?), effective-
Cost-Effective Model for Immunization Registries 115