The cost of immunising at the general practice level

Area of Science:

• Health economics
• Public health policy
• General practice management

Background:

• Childhood immunisation is a highly cost-effective healthcare intervention.
• New Zealand (NZ) struggles to meet national childhood immunisation coverage targets.
• NZ general practices, funded via fee-for-service, are key immunisation service providers.

Purpose of the Study:

• To calculate the average cost for NZ general practices to deliver childhood immunisation events.
• To create a cost model for a typical general practice's immunisation activities.

Main Methods:

• Activity-based costing was employed.
• Data were collected from 24 diverse general practices using questionnaires and daily logs over one week.

Main Results:

• The average cost per immunisation event was estimated at $25.90, with significant practice-to-practice variation.
• Practice nurses provided 90.7% of staff time for immunisation activities, averaging 23.8 minutes per event.
• Opportunistic immunisation activities constituted only 2% of total recorded staff time.

Conclusions:

• The current immunisation benefit subsidy in NZ is substantially lower than the actual cost per vaccination event.
• This cost-subsidy gap may discourage opportunistic immunisation and act as a barrier to improving overall immunisation rates.