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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 (β = 431.5, p < .001) and cases squared (β = −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.

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