reports

ACG use in Veterans Administration in Taiwan: final report

Taipei, Taiwan: Veterans General Hospital Taipei. Published in Chinese.

Department of Medical Affairs and Planning, Taipei Veterans General Hospital, Taipei City, Taiwan, ROC

The goal of this project is to develop a Veterans Healthcare Research Database (VHRD) and to assess veterans’ morbidity burdens and medical needs in Taiwan. With the technical supports from the Johns Hopkins ACG Group, the Adjusted Clinical Group (ACG) system was introduced to the VHRD in 2008. Anonomous and encrypted veteran-specific claims data from 2001 to 2007 were purchased from the National Healthcare Research Institute. Individual ACG-based morbidities and healthcare utilizations were calculated for each year. By far this is the first and up-to-date veteran claims database on a national basis. The veteran had on average 29 visits a year. The majority of visits were at non-veteran healthcare organizations and only 22% at the veterans system. Those with multiple morbidities were used to visit medical centers of veteran system, while they self-referred the minor illnesses to the primary care physicians or district hospitals. An estimate of 5.5% of all veterans had two or more hospital visits at the same day, while 20% of veterans had two or more speciality clinics in the same hospital. Cardiovascular speciality combined with neurology or ophthalmology were the most popular among all multiple physician shoppings at the TVGH. Two primary care clinics at the same day was the most popular combination based on national data. The study finding has been applied to the ongoing NHI’s integrated clinic project and VAC’s special project with an aim to trim unnecessary visits.