Original Investigation

Financial Hardship, End-of-Life Health Care Use, and Costs in Patients With Cancer

JAMA Network Open 10.1001/jamanetworkopen.2026.7923

April 20, 2026 at 11:00 AM EDT

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Do patients with cancer who struggle financially have more hospital-based and costly care at the end of life?This cohort study with 10 826 participants found that patients with cancer with new adverse financial events (eg, collections, liens, foreclosures) in the 2 years before death were 41% more likely to have multiple emergency department or hospital visits in the last 3 months of life, were 50% more likely to die in the hospital, and had higher end-of-life health care spending.These findings suggest that helping patients with cancer who are experiencing financial hardship could improve end-of-life health outcomes and costs.

Corresponding Author: Veena Shankaran, MD, MS, Clinical Research Division, Fred Hutch Cancer Center, 1100 Fairview Ave E, M3-B232, Seattle, WA 98109 (vshank@uw.edu).

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