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Risk index or morbidity burden was calculated for each center and physician. It shows the complexity of visited population in relation to a standard and is calculated as the ratio between the predicted mean pharmaceutical cost considering the ACG distribution and the mean pharmaceutical cost of the whole population studied. Efficiency index compares pharmaceutical expenditure among de graficos de video binary options opciones binarias and physicians assuming similar population complexity.

It is calculated as the ratio between the observed mean expenditure and the predicted mean expenditure adjusted for ACG.

Expenditure of centers and physicians were compared after adjusting for ACG using linear mixed models.

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Context variables, summarized in center, show little impact in variability. And physician related factors are only relevant in pediatric population.

Some other variables not recorded and measurement error may play a role in the observed variability. The accumulation of different kind of errors may be heterogeneous among centers and professionals. The main sources of errors are: deficient quality in patient record files, errors in diagnostic coding and in recoding from ICPC-2 to ICD-9-MC.