This research aims at building reliable information about the drivers of expenditures at municipality level that could be used to guide policy makers in the public health care organization. In addition, the spatial temporal structure of the dataset (built using administrative data) is investigated considering a panel data spa- tial error model for per capita expenditures. The results of model estimation and the demographic projections are employed for the long-run predictions of regional health expenditures in the well-known aging population framework characterizing the Italian health system.