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

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

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


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 white 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.

Original languageEnglish (US)
Pages (from-to)84-94
Number of pages11
JournalMedical Decision Making
Issue number1
StatePublished - 1998
Externally publishedYes


  • Decision making
  • Expected utility theory
  • Patients' preferences
  • Treatment choice

ASJC Scopus subject areas

  • Health Policy


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