Treatment choices by seriously ill patients: the Health Stock Risk Adjustment model

Anecdotal evidence suggests that patients who have life-threatening conditions often choose to undergo high-cost, high-risk treatments for them. This kind of risk-seeking behavior seems irrational because most patients are risk-averse. The Health Stock Risk Adjustment (HSRA) model seeks to explain t...

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Bibliographic Details
Published in:Medical decision making 1998-01, Vol.18 (1), p.84-94
Main Authors: Gaskin, D J, Kong, J, Meropol, N J, Yabroff, K R, Weaver, C, Schulman, K A
Format: Article
Language:English
Subjects:
Aged
Breast Neoplasms - psychology
Decision Making
Decision Theory
Female
Humans
Life Expectancy
Middle Aged
Quality-Adjusted Life Years
Risk-Taking
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Summary:Anecdotal evidence suggests that patients who have life-threatening conditions often choose to undergo high-cost, high-risk treatments for them. This kind of risk-seeking behavior seems irrational because most patients are risk-averse. The Health Stock Risk Adjustment (HSRA) model seeks to explain this phenomenon. The model is based on the concept of relative health stock--the ratio of patients' expected quality-adjusted life years (QALYs) after a diagnosis to their expected QALYs before the diagnosis. The model predicts risk-averse patients will behave in a risk-seeking manner as their relative health stocks deteriorate. The HSRA model can help physicians better understand why some seriously ill patients seek high-risk treatments while others elect to forgo treatment. State legislatures and insurers are attempting to appropriately design insurance benefits for patients with life-threatening conditions. The HSRA model can help predict which patients will most likely take advantage of these benefits.
ISSN:0272-989X
1552-681X
DOI:10.1177/0272989X9801800116