Associations between elective inpatient treatment and monthly earnings and employment: a national linked data study in England

Poor health is strongly linked to reduced employment, lower earnings, and long-term labour market disengagement. While elective inpatient treatments may improve health, their broader economic impact is not well understood. This study aimed to estimate the long-term relationship between elective inpatient treatment and labour market outcomes across a wide range of specialties in England. We conducted a retrospective, longitudinal study using linked administrative data, combining Hospital Episode Statistics, the 2011 Census, death registrations, and HMRC Pay As You Earn records. Adults aged 25–64 who received elective inpatient care between April 2015 and March 2023 across 32 specialties were included. Monthly earnings and employment status were measured before and after treatment and standardized for age. Interrupted timeseries models with data-driven breakpoints were used to estimate counterfactual labour market trajectories had treatment not occurred. Treatment effects were calculated as the difference between observed and modelled outcomes. Among 4.9 million patients, elective treatment was associated with improved earnings and employment relative to a counterfactual of continued health deterioration. At 60 months after treatment, the largest effects were observed in haematology, oncology, and renal medicine. Across all specialties, cumulative 5-year treatment effects ranged from £47.2 billion to £73.7 billion in additional earnings and from 198 918 to 745 262 person-years of employment. Elective inpatient treatment is associated with substantial and sustained labour market benefits. Receiving treatment may improve individuals’ ability to participate in work, with benefits persisting for many years after treatment, relative to the counterfactual.