Abstract / Summary
We analyse the effect of waiting time for elective musculoskeletal treatment on labour market outcomes in England using hospital records for working-age adults who received treatment between April 2015 and March 2023 to Census, tax and benefit records. To address clinical prioritisation and unobserved severity, we leveraged provider-level waiting time as an instrument for individual waiting time and estimated two-stage least squares models adjusted for baseline labour market outcomes, demographic and socioeconomic characteristics, and provider, referral-time and procedure fixed effects. We find that longer waits reduce annual employee earnings, with effects persisting for up to five years. For an additional four weeks of waiting, the largest estimated annual losses range from {pound}301 for osteoarthritis to {pound}487 for other joint disorders. There was no evidence of effects on employment status or benefit receipt, suggesting that delays primarily operate through reduced productivity or hours worked among those who remain employed. Reducing waiting times may not only improve health outcomes but help patients maintain earnings and support economic