Abstract
Regular, comprehensive, and effective cost analyses of immunization services are essential for evaluating whether current policy subsidies are suitable for these services. However, such studies are relatively limited in China. This study is the first comprehensive investigation of the costs of immunization services in Guangzhou City. Through stratified random sampling, we selected 84 vaccination clinics covering 11 administrative districts, including routine, adult, and rabies vaccination clinics. Investigate the vaccination service costs of various types of outpatient clinics. The cost investigation adopts the top - down full cost method to examine the labor costs, operating costs, and fixed - asset depreciation costs of each vaccination unit. In addition, it is need to clarify that vaccine procurement costs were not included in the scope of this cost analysis. Key findings revealed that the costs per dose (293.70 CNY,$41.66) and per person (433.96 CNY,$61.55) were significantly higher at adult vaccination clinics than routine vaccination clinics (per dose: 64.88 CNY($9.20); per person: 153.66 CNY($21.80)) and rabies vaccination clinics (per dose: 252.15 CNY($35.77); per person: 867.13 CNY($123.00)). For all surveyed vaccination units, labor costs accounted for the largest proportion of total costs (75.02%), and was followed by operational costs (19.67%) and fixed assets (5.31%). Univariate and multivariate regression analyses identified several factors influencing service costs. An increase in the standard number of staff per week was associated with higher vaccination service costs. Factors associated with lower vaccination service costs included clinics that were privately operated, served larger population sizes, offered services on more days per week, or had moderate to large vaccination areas. This comprehensive analysis provides valuable insights for optimizing resource allocation, improving vaccination accessibility across the life course, and informing policy development to support sustainable immunization programs.