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首页> 外文期刊>Journal of public health management and practice: JPHMP >Immunization information system opt-in consent: at what cost?
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Immunization information system opt-in consent: at what cost?

机译：选择接受免疫信息系统同意：费用是多少？

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摘要

Immunization information systems (IISs) are confidential, population-based systems that contain immunization data for children, and, in some cases, adults, within a geographic area. There are generally two models for participation in an IIS, termed voluntary exclusion or "opt-out" and voluntary inclusion or "opt-in." Using the Texas opt-in consent system and statewide IIS (ImmTrac), we describe the costs associated with obtaining opt-in consent in hospitals as part of the birth registration process and in provider offices for children without prior consent. We also estimate the costs associated with a hypothetical opt-out system. Between October 2006 and August 2007, project staff conducted on-site time studies for patients in 8 birthing hospitals (n = 281), 16 provider offices (n = 131), and ImmTrac state offices in Austin, Texas (n = 100). Total costs per child and costs per year were estimated using a time-and-motion study in which the time associated with discussing ImmTrac and obtaining ImmTrac consent was measured. The annual costs associated with obtaining consent for Texas' opt-in IIS are estimated at Dollars 1 389 804.61. The average per child cost associated with ImmTrac consent completed at birth is Dollars 2.00, whereas the per child cost for consent completed in provider offices is Dollars 2.64. The annual costs of operating an alternative, opt-out system are estimated at Dollars 110 714.03, or Dollars 0.29 per child. This cost analysis demonstrated that the proposed opt-out costs were substantially less than the actual opt-in model currently utilized. Changing to an opt-out system could redirect limited healthcare funding to more critical areas such as vaccine purchasing and administration.
机译：免疫信息系统（IIS）是基于人口的机密系统，其中包含某个地理区域内儿童（有时是成人）的免疫数据。通常，有两种参与IIS的模型，称为自愿排除或“选择退出”和自愿纳入或“选择加入”。使用德克萨斯州的选择加入同意系统和全州IIS（ImmTrac），我们描述了在出生登记过程中医院和未经事先同意的儿童提供者办公室中获得选择加入同意的相关费用。我们还估算了与假设的退出系统相关的成本。在2006年10月至2007年8月之间，项目人员对8家分娩医院（n = 281），16家医疗服务提供者办公室（n = 131）和德克萨斯州奥斯丁（I = 100）的ImmTrac州办公室的患者进行了现场时间研究。每个孩子的总成本和每年的成本是通过一项时间和运动研究估算出来的，该研究测量了讨论ImmTrac和获得ImmTrac同意的时间。与获得德克萨斯州选择加入的IIS的同意相关的年度成本估计为1 389 804.61美元。与出生时完成ImmTrac同意书相关的每个孩子的平均费用为2.00美元，而在提供者办公室完成的同意书中的每个孩子的费用为2.64美元。使用替代选择退出系统的年度成本估计为110 714.03美元，或每个孩子0.29美元。这项成本分析表明，拟议的退出成本大大低于当前使用的实际退出模式。更改为退出系统可以将有限的医疗保健资金重定向到更关键的领域，例如疫苗购买和管理。

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