The Economic Cost of Communicable Disease Surveillance in Local Public Health Agencies

Objective. We identify economic costs associated with communicable disease (CD) monitoring/surveillance in Colorado local public health agencies and identify possible economies of scale. Data Sources/Study Setting. Data were collected via a survey of local public health employees engaged in CD work. Survey respondents logged time spent on CD surveillance for 2-week periods in the spring of 2014 and fall of 2014. Forty-three of the 54 local public health agencies in Colorado participated. Study Design. We used a microcosting approach. We estimated a statistical cost function using cost as a function of the number of reported investigable diseases during the matched 2-week period. We also controlled for other independent variables, including case mix, characteristics of the agency, the community, and services provided. Data Collection/Extraction Methods. Data were collected from a microcosting survey using time logs. Principal Findings. Costs increased at a decreasing rate as cases increased, with both cases ([beta] = 431.5, p < .001) and cases squared ([beta] = -3.62, p = .05) statistically significant. Conclusions and Implications. The results of the model suggest economies of scale. Cost per unit is estimated to be one-third lower for high-volume agencies as compared to low-volume agencies. Cost savings could potentially be achieved if smaller agencies shared services. Key Words. Public health services and systems research, communicable disease surveillance, economies of scale
In 2012, the Institute of Medicine published a report entitled For the Public's Health: Investing in a Healthier Future, which included a call to action toward the development of a [...]