Impact of elective inpatient treatments on monthly earnings and employment: a national linked data study in England

ObjectiveEvaluate the impact of elective inpatient hospital care on monthly earnings and employment status among working-age adults. DesignInterrupted time series analysis using national, linked administrative datasets. SettingHospital inpatient services in England between 1 April 2014 and 31 March 2023. Participants5,762,437 individuals who 1) had at least one elective (non-emergency) inpatient admission recorded in NHS Hospital Episode Statistics (HES) starting on or after April 2015 and finishing on or before March 2023; 2) had a treatment specialty code from a specified list; 3) were aged 30 to <59 years at the date of treatment; 4) could be linked to national census and taxation information. Main outcome measuresMonthly employee pay expressed in 2023 prices and paid employee status. ResultsWe found that elective inpatient treatments were associated with improved long-term economic outcomes relative to a counterfactual scenario of untreated health deterioration across a range of treatment specialties. At 60 months post-treatment, patients treated under the Clinical Haematology Service exhibited the largest treatment effect on earnings: by the end of the five-year outcome period, treated individuals earned {pound}1,805 more per month than the counterfactual. Patients treated under the Clinical Oncology Service showed the largest treatment effect on employment at 60 months, with an employment rate 29.9 percentage points higher than the counterfactual at the end of the outcome period. Across all treatment specialties, the total cumulative effect over the five-year outcome period was {pound}47.2 - 73.7 billion in earnings and 198,918 - 745,262 person-years of employment. ConclusionsReceiving elective inpatient treatment under a range of specialities was found to have a sustained positive impact on both earnings and employment rates across a five-year follow-up period. This suggests that receiving treatment may lead to improved participation in the labour market, contributing to economic growth, and the benefit of this persisting many years after the treatment itself was received. Summary boxO_ST_ABSSection 1: What is already known on this topicC_ST_ABSO_LISmall studies focusing on singular treatments have suggested that there is an improvement in labour market outcomes after treatment for health conditions C_LI Section 2: What this study addsO_LIOur study suggests that across a range of treatment groups, there is a positive treatment effect on both pay and employment, which would not have been observed had treatment not taken place C_LIO_LIOur study builds on previous research by utilising a linked population-level dataset for England, incorporating electronic health records, sociodemographic information from the national census, and pay data collected for tax purposes, with five years of follow-up across of breadth of treatments C_LI