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Immunization information system opt-in consent: at what cost?

Julie A Boom1, Leila C Sahni, Cynthia S Nelson

  • 1Immunization Project, Texas Children's Hospital, Houston, TX 77030, USA. jboom@bcm.edu

Journal of Public Health Management and Practice : JPHMP
|May 1, 2010
PubMed
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Implementing an opt-out consent system for immunization information systems (IISs) is significantly more cost-effective than an opt-in model. This shift could save healthcare funds for essential services like vaccine procurement and administration.

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Area of Science:

  • Public Health
  • Health Informatics
  • Health Economics

Background:

  • Immunization Information Systems (IISs) are crucial for tracking vaccination records.
  • Two primary participation models exist: opt-in (voluntary inclusion) and opt-out (voluntary exclusion).
  • Texas utilizes an opt-in consent system (ImmTrac) for its statewide IIS.

Purpose of the Study:

  • To analyze the costs of obtaining opt-in consent for the Texas IIS (ImmTrac).
  • To estimate the costs of a hypothetical opt-out consent system for comparison.
  • To evaluate the financial implications of different IIS participation models.

Main Methods:

  • A time-and-motion study was conducted in Texas hospitals, provider offices, and IIS state offices.
  • Data collection occurred between October 2006 and August 2007.
  • Costs were calculated based on measured time spent discussing and obtaining consent.

Main Results:

  • The annual cost for Texas' opt-in IIS consent was estimated at over $1.38 million.
  • Per-child consent costs were $2.00 at birth and $2.64 in provider offices.
  • An opt-out system was estimated to cost approximately $110,714 annually, or $0.29 per child.

Conclusions:

  • The opt-out IIS model is substantially less expensive than the current opt-in model.
  • Transitioning to an opt-out system could free up healthcare resources for vaccine purchasing and administration.
  • Cost-effectiveness analysis supports the adoption of opt-out consent for IIS.