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This article introduces the report on the difference occurred in management of ALS patients by an italian Public Health Care Service through 15 years with-and without DTCP (Diagnostic and Therapeutic Care Pathway) during three timeframes. The article illustrates Demography, Provenance and Territorial context of the patients in charge. The formalization of the staging-based ALS DTCP appears to have increased and improved the possibility of clinical taking in charge of patients.