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The cost to immunize during well-child visits
J Fontanesi1, M De Guire, K Holcomb
1Partnership of Immunization Providers, Department of Pediatrics, University of California, 9500 Gilman Dr, MC 0927, La Jolla, CA 92093-0927, USA. jfontanesi@ucsd.edu
Insights
Immunizations during well-child visits incur opportunity costs for healthcare providers. Increased preventive care recommendations necessitate reevaluating visit times and clinic efficiency.
Area of Science:
- Healthcare Management
- Pediatric Primary Care
- Health Economics
Background:
- Ambulatory care settings face increasing demands for preventive services.
- Immunization coverage rates are often low in underserved areas.
- Patient-provider contact time has significantly increased.
Purpose of the Study:
- To determine the incremental labor or opportunity costs of providing immunizations in ambulatory care.
- To analyze the impact of immunizations on well-child visit duration.
Main Methods:
- A time and motion analysis was conducted in 15 primary care practices (10 community clinics, 5 private practices).
- Practices were located in Health Professional Shortage Areas.
- Well-child visits with and without immunizations were compared based on duration.
Main Results:
- Immunizations represent an opportunity cost during well-child visits.
- Average patient-provider contact time was found to be longer than previously reported.
- The duration of well-child visits varied depending on whether immunizations were administered.
Conclusions:
- Increased immunization requirements impact the efficiency of primary care visits.
- Current healthcare system parameters, including visit time and reimbursement rates, require reevaluation.
- Optimizing clinic systems is crucial for meeting preventive care mandates.
Abstract:
The objective of this study was to determine the incremental labor costs or opportunity costs associated with the provision of immunizations in ambulatory care settings. A time and motion analysis of primary care health visits by pediatric patients was performed in 10 community clinics and 5 private primary care practices. These clinics and practices were located in areas designated as Health Professional Shortage Areas, with traditionally low immunization coverage rates and other unmet primary care needs. The outcome measure for this study was the comparative duration of the visit, contrasting well-child visits during which immunization was given with well-child visits during which no immunization was given. The results suggested that immunizations present an opportunity cost during well-child visits. The average time of patient-provider contact found in this study supports other findings showing that this time is now significantly longer than that reported in the past. In order for providers to comply with increased recommendations and requirements for preventive health care services, the allotted visit time, capitation rates, and overall clinic system effectiveness need to be reexamined.