For the first time, the Fondazione Sanità Futura compares the results of the Lombard public and private health network with the national health system and with that of the individual regions, processing the data of the National Outcomes Plan of Agenas 2017-2019. A measurement of the effectiveness of healthcare services relating to the 2016-2018 period which shows the excellence of the Lombard public-private system which records the best results in 34 indicators out of the 42 analyzed, equal to 88% of the national average. A result to which public health contributes, 62% higher than the national average (26 indicators out of 42), as well as private health, which achieves a quality percentage of 76% compared to the national average (32 indicators out of 42). Lombardy, as a regional health system, is 9 times out of 10 higher than the national average, confirming the added value of the integration between public and private. Among the many excellences, the study indicates that 1) in the treatment of heart attack the weighted average mortality at 30 days in Lombard public health is 7.67 against the national figure of 8.32; in the Lombard private health sector it is at 6.36 against the 6.71 of the national private health system 2) in the treatment of aneurysm the Lombard public health as a 30-day mortality is at 1.50 against the 1.60 of the national public health ; in the Lombard private health sector it is 0.66 against the 1.03 of the national private health system 3) in the treatment of stroke the Lombard public health is at 9.45 against the 10.32 of the national public health; in the private sector Lombardy is 8.48 against 8.57 for the national private health system; 4) in the treatment of lung cancer, the Lombard public health indicator is 0.74 against 0.92 for public health; Lombard private health care is 0.93 against 1.55 for national private health care 5) in the treatment of rectal cancer, the weighted average of Lombardy in public health in Lombardy is 7.67 against 8.32 of the weighted national average ; in the private sector in Lombardy it is 6.36 compared to 6.71 in the national private health system. ” Quality of clinical outcomes in hospitals. Comparison between the Lombardy Region and the other regions’ (Franco Angeli edition): this is the title of the study developed by Fondazione Sanità Futura and coordinated by Prof. Gabriele Pelissero with the technical collaboration of the consulting company Innogea Srl, with the scientific support of Pavese Consortium for post-graduate studies in the health area, Confindustria Lombardia Sanità e Servizi and Aiop Lombardia. A panoramic picture of the ‘quality outcomes’ of hospital services provided by public and private structures, region by region, compared with the services of Lombardy, through data from the National Outcome Program (PNE), developed by Agenas (National Agency for Services regional health care) on behalf of the Ministry of Health. In the 140-page report, through tables, statistics and analytical cards, 42 ‘outcomes’ are measured, i.e. outcome indicators that quantify the improvement or worsening of the patient’s state of health in different intervention situations. “The research” – reads the premise of the study – “does not intend to establish rankings or rankings of merit between public and private or between the various regions, but to evaluate whether and to what extent the different regional organizational models, the different size of hospital structures , the cases dealt with and the differences in their management affect the quality of the health services provided “. An “instruction manual on what we must improve together” and a contribution also to overcome the “often ideological and prejudicial system of many current disputes” on erroneous conflicts between public and private “. The aim is also to invite constructive reflection on a system such as the Lombard one challenged by the Covid emergency without adequate attention to the actual measurement of performance and quality of services. A system that the Agenas outcome indicators reveal to be a model at national level, as confirmed by other often forgotten system data. Until the slowdown dictated by the Covid-19 pandemic, in fact, the Lombard structures – according to the SDOs, the 2018 hospital discharge forms – welcomed over 22% of non-regions, with a positive mobility balance (the difference between those who left and those who entered the Region in search of health services) of 100,641 patients. The contribution of the Lombard health system to scientific research is also fundamental, through the IRCCS, the Scientific Hospitalization and Care Institutes, with a contribution of 77% to the total national public research and 52% to the total of the private one. ‘intent of the volume is to provide a qualified contribution to deepen studies on hospital performance, thus consolidating a’ value based healthcare ‘model. A model that could become the main reference for the qualitative growth of regional health services. “The Lombard system in its interaction between public and private sectors has created a constant tension towards quality over the years” declares Dario Beretta, president of Aiop Lombardia. The forced lack of treatment, but also the slowdown in prevention and screening activities for early diagnosis determined by Covid, together with the prospect of completing the vaccination campaign, puts us all in front of the responsibility and the need to restart the engine of health public and private at full capacity. Everyone must make every effort to make up for the time lost in the treatment of other non-Covid diseases and limit the effects of the wave of return that this situation will determine in the coming years. Lombardy healthcare with its excellence is, as always, ready to do its part and to welcome patients from all over Italy “.