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Treatment Choices by Seriously III Patients

Author

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  • Darrell J. Gaskin
  • Janet Kong
  • Neal J. Meropol
  • K. Robin Yabroff
  • Charles Weaver
  • Kevin A. Schulman

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 under stand 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. Key words: patients' preferences; decision making; expected utility theory; treatment choice. (Med Decis Making 1998;18:84-94)

Suggested Citation

  • Darrell J. Gaskin & Janet Kong & Neal J. Meropol & K. Robin Yabroff & Charles Weaver & Kevin A. Schulman, 1998. "Treatment Choices by Seriously III Patients," Medical Decision Making, , vol. 18(1), pages 84-94, January.
    • Handle: RePEc:sae:medema:v:18:y:1998:i:1:p:84-94
    DOI: 10.1177/0272989X9801800116
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    References listed on IDEAS

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