Abstract Physical exercise plays a pivotal role in primary and secondary prevention of non–communicable chronic diseases. Nonetheless, to date, exercise prescription to chronically ill subjects is not yet in line with guidelines indications. In Veneto region, the goal of reducing the gap between guidelines and their actual application has been pursued for several years thanks to a regional “model”of exercise prescription in chronic disease. However, regional data indicative of the real clinical impact of this "model" are lacking. We evaluated the impact of the regional model on a population of chronically ill people visited at our Clinic between 2014 and 2019. In this period, 366 subjects living in the province of Treviso (Veneto region, Italy) with a history of heart disease and/or diabetes have been admitted to our facility and have been provided with precise indications (in the form of prescription) about physical exercise to be practiced in secondary prevention. For each subject, adherence to the exercise prescription was assessed. The study population was therefore divided into 3 classes of activity in accordance with the physical activity practiced during the observation period: 0=not adherent at all at the exercise prescription (no exercise practice phase); 1= practice of unstructured physical activity/ not monitored physical exercise and/or not completely adhering to the exercise prescription in terms of intensity, duration and frequency; 2= practice of structured and monitored physical exercise, completely adherent to exercise prescription provided. By this way, any temporary suspension and subsequent resumption of the activity was considered and the period of cessation of the activity during the monitoring period was taken into account for each subject. Data on “health expenditure”, was collected for each subject at time zero as new hospitalizations and deaths were analyzed following our intervention (exercise prescription letter delivery). According to a preliminary analysis of our data, time spent in practicing exercise in class 1 and 2 lead to a significant improvement in survival and less hospitalizations for considered pathologies. Furthermore, time spent in class 2 exercise practice (structured and monitored physical exercise, at target for intensity, duration and frequency), seems to determine even greater protection compared to unstructured physical activity or structured but not monitored and/or non–targeted physical exercise (class 1).