Abstract
Standard costs in health were introduced through L. 42/2009, which envisages its progressive use, with full implementation by 2017. The concept, shared, can not find a practical application in this sector because to the different characteristics of patients, comorbidities present, and the number of possible performances. The problem can be shifted from cost to performance to standard resource allocations with the conceptualization of needs, by measuring the use of services based on patient-based analysis. The latter exploits the payment model for performance to classify the assisted and measure the spending for each cluster: practical applications are already found in Italy and the North American continent, where some insurance and health service use it to provide the expenditure for health ventures. Experimenting with the simplified model for age standards of a region of northern Italy there are observed decreases/increases for each health service and an overall saving of 600 million €. The model also lends itself to modify the payment system (from activity to cure) and support 'outcome' systems such as cluster analysis of patients.