Abstract
Measuring the performance of Public Health Authorities is a necessary step to ensure the effectiveness of the control systems, to share and exploit results as well as to enable learning processes. Although the issue of performance measurement is now a central issue also in the public health sector, in practice there is neither a solid culture nor substantial experience in this area, particularly with reference to the thematic role that it plays in support to decision-making processes, that are often conducted by qualitative assessments. The experience of the Lombardy Region represents a first attempt to structure legislation through the instrument of "Guidelines", addressed to general directors of public health authorities, regarding the definition of a system of measurement and evaluation of performance. Despite its weaknesses, such a document, developed on the model by panel of experts, intends to operationally support the actors in the Regional Health System by measuring not only the effective capacity of the public sector to create value, but also to effectively communicate to the citizen, the central subject of the service delivery process.