Cohort study of financial hardship, end-of-life health care use, and costs in patients with cancer

Patients with cancer are at higher risk of adverse financial events (AFEs) compared with individuals without cancer. Little is known about how personal finances affect cancer care, particularly at the end of life (EOL). A retrospective cohort study using Western Washington SEER data evaluated the association of financial struggles and hospital-based and costly care at EOL. This cohort study with 10,826 participants found that patients with new AFE (eg, collections, liens, foreclosures) in the 2 years before death were 41% more likely to have multiple emergency department or hospital visits, were 50% more likely to die in the hospital, and had higher EOL health care spending. The authors conclude that these findings suggest that helping patients with cancer who are experiencing financial hardship could improve EOL outcomes and costs.