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Adjustment for ACGs allows a much fair comparison of expenditures among centers and physicians. We also show that pharmaceutical expenditure correlates negatively with a prescription quality index more strongly when adjusted for ACGs, which can be interpreted as evidence that, when complexity of the patients is accounted for, better quality of prescription is associated with lower expenditure.

In this analysis adult and pediatric data have been analyzed separately because their distribution is different and the proportion of expenditure variance explained for the main factors is also different. Possibly this shape is due to the patients with chronic medication that have higher costs, but we have no data to prove it because this variable was not available.