Economic Cost of Communicable Disease Monitoring in Colorado

Although many different national organizations, including the Institute of Medicine, have called for the development of a minimum package of public health benefits, little is known about the cost providing essential population-based public health services. This lack of knowledge results in an inability to make a clear financial case for public health and limits the amount of informed decision-making that can be done by public health leaders. In our project, we identify the economic costs associated with Communicable Disease Monitoring/ Surveillance.  To estimate the cost of the services, we use a micro-costing approach with a series of key informant interviews and focus groups to identify major variable and fixed costs associated with the services to develop a survey to collect cost data.  To calculate marginal costs, we used daily activity logs recording activities during each 30 minute interval of work over a two week time period. We augment the cost survey with a manager survey asking about the number of FTE’s associated with each activity and also the number of staff hours. We compare the cost estimations using the two methods (activity logs and manager survey) to determine the validity of the logs. Once we have an estimate of the time associated with activities, we will calculate the per-hour cost of each staff member type, including both wages and benefits using accounting data from the agency. We also estimate the capital cost associated with the program using rental costs of similar spaces (or actual rental costs, if applicable).   Methodologically, we estimate a statistical cost function using cost (from the microcosting data) as the dependent variable and difference characteristics as the independent variables, including characteristics of the agency, the community and services provided. In the cost estimation, we will use a standard log-linear model estimated using Ordinary Least Squares.