The use of performance indicators to measure quality of care is a central component of healthcare policies to support decision-making. In Italy the National Outcomes Evaluation Programme (PNE) is the most comprehensive comparative evaluation of healthcare outcomes at the national level, based on data from the Hospital Information System (HIS) and the National Tax Registry (NTR). The aim of this study is to better understand the changes occurred in Italy during the pandemic and post-pandemic periods in specific nosological areas, compared to the pre-pandemic period. COVID-19 has had a strong impact on hospital care, resulting in 1.7 million fewer hospitalisations in 2020. This reduction was moderate for urgent admissions (−13%) and more marked for scheduled admissions (decreased by about a quarter). In 2021, there was a resumption of hospital activity. However, a reduction of 14% compared to 2019 persists (corresponding to about 1.2 million fewer hospitalisations). In 2022, there was a further increase in hospital admissions, compared to the previous year, and the realignment of volumes to pre-pandemic levels continued, although 10% of hospitalisation were still missing compared to 2019. This realignment involved both scheduled and DH admissions, while emergency admissions remained stable confirming 13% decrease compared to 2019, similar to that recorded in 2020 and 2021. The study highlighted a certain degree of resilience of the Italian NHS, despite the critical aspects affecting the health care organisation and that the pandemic has exacerbated.