Measurement of public sector performance, when his offer foundamental service (health, transportation, instruction, gustice ecc), is an important issue in the economic debate, for researcher and for policy maker. The quantity of public or private provision have direct impact on welfare and are important for the economics growth. In this paper measurement of performance issue is considered in term of relative efficiency of regional health care systems in Italy, where is principally public financed. Question remain rilevant even when state of country s overall health, in terms of life expectancy and rate of mortality, are in significant improvement. But we most not overlook the impact of risk factor, individual and collective, as the quality of life, individual lifestyle and socio-economics factors on the health status, directly, and therefore the level of health resources available for obtain the health status of population. So this paper to try consider the influence of such factor on the inefficiency of regional health care systems, later relative efficiency is derived for each regional health care system. In this direction Retzlaff et alt (2004) considering technical efficiency in the production of aggregate health status of the population in OECD country, and use results for policy indication. The present work is at Italys health care system level that is organized at three government level: central, regional and local level. At central level the main institutions are the Ministry of Health, which ran the National Health Fund, abolished by Legislative Decree 56/2000 and to be replaced by various regional taxes
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