KEYWORDS:
Cost Analysis, Cost-effectiveness Analysis, Non-traditional Clinics

BACKGROUND:
Since 1994, the Houston Department of Health and Human Services (HDHHS) has provided immunization services through permanent comprehensive health facilities as well as through “immunization-only non-traditional clinics” located at Fiesta food stores, Walgreens, libraries, and recreational centers. In order to decide if non-traditional clinics should receive continued support, HDHHS collaborated with CDC/National Immunization Program to evaluate the relative cost-effectiveness of permanent versus non-traditional clinics.

OBJECTIVE(S):
To assess the cost-effectiveness of delivering vaccines in permanent versus non-traditional clinics(NTC).

METHOD(S):
Data on vaccine doses administered at 8 permanent and 28 NTCs were obtained from 1995 to 1999 through routine reporting systems. Cost components, including personnel (salary, fringe and indirect costs), travel and supplies costs, were estimated. Cost-effectiveness ratio, defined as cost per dose of vaccine administered, was calculated by type of clinic. The cost-effectiveness ratios of individual NTCs were also compared.

RESULT(S):
In 1999, the cost per dose of vaccine administered by permanent clinics and NTCs, was $4.98 and $4.58 respectively. The cost-effectiveness ratios varied by NTC, with 2 clinics exceeding $8 per dose administered.

CONCLUSIONS(S):
The cost for operating NTCs compares favorably with the cost of operating permanent clinics. Two of the NTCs, were identified as less cost-effective compared with other NTCs.

LEARNING OBJECTIVES:
Understand how the vaccine delivery system may be assessed using economic methodology.