Cost-effectiveness of childhood immunization reminder/recall systems in urban private practices

Objective. To assess cost and cost-effectiveness of immunization reminder/r ecall systems in the private sector. Methods. A manual postcard system (mail) was compared with a computer-based telephone system (autodialer) and control. Costs included time costs and t he cost of equipment and supplies. The cost per child and the incremental c ost of the intervention relative to control were computed. Cost-effectivene ss ratios were computed for return visits and for immunizations delivered. Results. The average cost per child was $2.28 for the mail group and $1.47 for the autodialer group. The incremental visit cost relative to the contro l was higher for the mail group ($9.52) than for the autodialer group ($3.4 8). The autodialer was more cost-effective in delivering immunizations: $4. 06 per extra immunization (autodialer) versus $12.82 (mail). Conclusions. Excluding start-up costs, the autodialer system was most cost- effective. Including autodialer equipment costs, the autodialer system is m ore cost-effective only for larger practices.