Govert Veldhuijzen

123 CBE before colonoscopy is reducing operational costs, with lower patient and societal expense To educate a single patient using CBE, the endoscopy unit paid on average €8.36 (95% CI: €7.83-€8.84) per patient. Nurse counselling resulted in significantly higher costs: €22.56 (95% CI: €22.00–€23.12). Significance was confirmed as bootstrapping did not show overlap of the presented confidence intervals. Patients The cost per kilometre, based on the iTMA costing tool, was €0.19 and average hospital parking fees were €3.03. 23 Travel distance was on average 14.5 kilometres. 24 Therefore, the total expenses for a patient to obtain nurse counselling was €5,80. With mandatory visits in 100% and 3% of the cases, the total cost made by all patients was €1260,09 for nurse counselling versus €46.45 for CBE. Corrected costs for sample size in both groups (217 versus 280 patients, correctional factor 1.29) are € 1625,93 in nurse counselling versus €46.45 in the CBE group. Patient education via CBE results in a 97.1% reduction of patient expenditure. Society - Productivity loss In total 271 patients (125 nurse, 146 CBE group) completed the iMTA questionnaire. (Table 2.) Important factor in this questionnaire is distribution of gender, as males are attributed higher wages. This was equally distributed in both groups. Table 2. Results of 271 patients filling out the IMTA questionnaire Nurse counselling N =125 Computer based education N = 146 p value (statistical test) Male, n (%) 58 (46,4%) 67 (45,9%) p = 0.2 (Chi-Square) Productivity loss reported, n (%) 54 (43.2%) 29 (19.8%) P = 0.007 (Chi Square)  Paid work 28 (22.4%) 6 (4.1%)  Unpaid work 1 (0.8%) 1 (0.7%)  Replaced unpaid work 25 (20%) 22 (15.1%) Average hours absent, mean (SD) 3.43 (SD 1,98) 3.83 (SD 2,74) P = 0.49 (independent t-test) Total productivity loss (95% CI) €35,84 (€ 26,79 -€48,41) €13,89 (€7,64 – €18,84) Productivity loss was defined by absence from either 1. paid or 2. unpaid work or 3. needing replacement for unpaid work. Patients who were counselled by nurses reported productivity loss in 54 (43.2%), while this was 29 (19.8%) for patients who received CBE (p=0.007). Main cause for this relevant difference was the category of patients reporting absence of paid work, 28 (22.4%) in the nurse counselling group versus only 6 (4.1%) in the CBE group. The mean number of hours reported was not significantly different. 6