Tailoring childhood immunisation services in a socioeconomically disadvantaged community in New South Wales, Australia: a cost analysis
Susan Thomas A B * , Kirsten Williamson B , Rod Ling
A C , Xenia Dolja-Gore A , Fakhrul M. Islam B , Helen Higgins B , David N. Durrheim A B and Andrew Searles A C
A University of Newcastle, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia.
B Hunter New England Local Health District, Population Health (HNEPH), Wallsend, NSW 2287, Australia.
C Hunter Medical Research Institute, New Lambton Heights, NSW 2350, Australia.
Australian Journal of Primary Health 28(6) 490-497 https://doi.org/10.1071/PY22071
Submitted: 23 March 2022 Accepted: 5 September 2022 Published: 4 October 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Using the World Health Organization’s ‘Guide to Tailoring Immunization Programmes’ (TIP), a three-step program was developed by health services in partnership with a marginalised community in New South Wales, Australia. The aim was to improve immunisation rates of 1-year-old children. For Step 1, nurses identified and monitored local children overdue for immunisation from a national register, and sent parents or family doctors reminders by mail or telephone. For Step 2, parents were offered appointments at a local health centre; and for Step 3, they were offered home visits.
Methods: An economic costing study was undertaken to examine the program’s resource use. Costs were collected between 1 June 2020 and 31 May 2021. Case records were obtained for 139 children.
Results: A total of 56 children became up to date after receiving TIP services; most after receiving Step 1 services (n = 37). Total annual costs (A$) for the program were $34 250 or $246 per case; or $612 per case becoming up to date. At $44 per case and $98 per case becoming up to date, Step 1B: personalised reminders, was the lowest costing step. Sensitivity analysis showed a possible 8% program savings through employment of nurses with a lower salary and use of video conference meetings.
Conclusion: This study provides information to the local health provider on the cost of TIP alongside their community-based programs. It also identified ways in which TIP could be made more cost-effective. Decision-makers can use this information to consider whether the investment in TIP is recommended.
Keywords: community health: services, equity, health care: costs, immunisation programs, primary health care.
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