Finding the Socioeconomic Gradient in Knee Arthroscopies: A Descriptive Study of the Horizontal Equity in the Swedish Orthopedic Sector

Abstract: Research on the graded association between socioeconomic status and healthcare access for non-fatal diseases has expanded in recent years. Since burdens from non-fatal diseases are increasing globally, and health expenditures represent a growing share of GDP in most developed countries, the phenomenon is worth studying through an economic lens. The purpose of this thesis is to investigate the horizontal equity in the Swedish orthopedic healthcare sector. We ask if there exists a socioeconomic gradient in the probability that a patient receives a knee arthroscopy, when diagnosed with a knee condition where an arthroscopy is a possible treatment. We develop a linear probability model with individual level register data on all patients (996,324) from the time period 2002-2016 that received a first-time knee diagnosis or a first-time knee arthroscopy in Sweden. Our results show a significant (p<0.01) positive association between socioeconomic status and the likelihood of receiving a knee arthroscopy. Whether the association is small or large is debatable. Future research could replicate our model to see whether a socioeconomic gradient exists for other conditions and treatments.