Why Is End-of-Life Spending So High? Evidence from Cancer Patients

We study the sources of high end-of-life spending for cancer patients. Even among patients with similar initial prognoses, spending in the year postdiagnosis is over twice as high for those who die within the year than those who survive. Elevated spending on decedents is predominantly driven by higher inpatient spending, particularly low-intensity admissions. However, most such admissions do not result in death, making it difficult to target spending reductions. Furthermore, end-of-life spending is substantially more elevated for younger patients, compared to older patients with similar prognoses. Results highlight sources of high end-of-life spending without revealing any natural "remedies."