Treatment choices by seriously Ill patients: The health stock risk adjustment model

被引:23
作者
Gaskin, DJ
Kong, J
Meropol, NJ
Yabroff, KR
Weaver, C
Schulman, KA
机构
[1] Georgetown Univ, Med Ctr, Div Gen Internal Med, Clin Econ Res Unit, Washington, DC 20007 USA
[2] Georgetown Univ, Med Ctr, Inst Hlth Care Res & Policy, Washington, DC 20007 USA
[3] Roswell Pk Canc Inst, Div Med, Buffalo, NY 14263 USA
[4] Response Oncol Inc, Memphis, TN USA
关键词
patients' preferences; decision making; expected utility theory; treatment choice;
D O I
10.1177/0272989X9801800116
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
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.
引用
收藏
页码:84 / 94
页数:11
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