McLeod D, Bowie R D, Kljakovic M
Department of General Practice, Wellington School of Medicine.
N Z Med J. 1998 Mar 13;111(1061):73-6.
To estimate the cost, to general practices in the Wellington Immunisation Network, of the audit process of recalling and immunising children according to the New Zealand Immunisation Schedule.
Practices recorded all clinical and clerical time spent on immunisation as well as the materials used throughout one audit cycle. Staff time and materials were costed directly. Practice overheads were apportioned to immunisation according to the actual time spent on each of the tasks relating to immunisation relative to the total staff hours at the practice.
The average cost of immunising a child who attended a non-capitated practice after a single reminder or recall was $15.15. The cost to the practice after taking the practice nurse subsidy and GMS into account was $8.51. The cost of immunising children who were not immunised at the first recall increased in proportion to the number of recall reminders. The annual average cost of immunisation to practices in the study exceeded the revenue obtained from the Immunisation Benefit.
Overall, given the frequency of recall reminders, there was a net cost to practices for childhood immunisation after deducting the current immunisation benefit rate of $9.78 excluding GST. Thus, the practices in this study made a "loss" in carrying out childhood immunisations.
评估按照新西兰免疫接种计划对儿童进行召回和免疫接种的审核流程给惠灵顿免疫接种网络中的全科诊所带来的成本。
诊所在一个审核周期内记录所有花费在免疫接种上的临床和文书工作时间以及所使用的材料。员工时间和材料直接计算成本。诊所间接费用根据与免疫接种相关的各项任务实际花费的时间相对于诊所总员工工时的比例分摊到免疫接种上。
在单次提醒或召回后,为参加非人头付费诊所的儿童进行免疫接种的平均成本为15.15美元。考虑到诊所护士补贴和普通医疗服务(GMS)后,诊所的成本为8.51美元。首次召回时未接种疫苗的儿童的免疫接种成本随着召回提醒次数的增加而按比例上升。该研究中诊所免疫接种的年度平均成本超过了从免疫接种补贴中获得的收入。
总体而言,考虑到召回提醒的频率,扣除当前不含商品及服务税(GST)的9.78美元免疫接种补贴率后,儿童免疫接种给诊所带来了净成本。因此,本研究中的诊所开展儿童免疫接种出现了“亏损”。