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

Med Decis Making. 1998 Jan-Mar;18(1):84-94. doi: 10.1177/0272989X9801800116.

Abstract

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.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Breast Neoplasms / psychology
  • Decision Making*
  • Decision Theory*
  • Female
  • Humans
  • Life Expectancy
  • Middle Aged
  • Quality-Adjusted Life Years*
  • Risk-Taking*