Management and efficiency have a fundamental impact on the performance of public hospitals, as well as on their philanthropic mission. Various studies have shown that the financial weaknesses of these entities affect the planning, setting of goals and objectives, monitoring, evaluation and feedback necessary to improve health systems and guarantee accessibility as an inalienable right. This study aims to analyze the management and efficiency of third-level and/or high-complexity hospitals in Colombia, through a statistical model that uses financial analysis and key performance indicators (KPIs) such as ROA, ROE and EBITDA. A non-experimental cross-sectional design is used, with an analytical-synthetic, documentary, exploratory and descriptive approach. The results show financial deficiencies in the hospitals evaluated; hence it is recommended to make adjustments in the operating cycle to increase efficiency rates. In addition, the use of the KPIs ROA and ROE under adjusted models is suggested for a more precise analysis of the financial ratios, since these adequately explain the variability of each indicator and are appropriate to evaluate hospital management and efficiency, but not in EBITDA ratio, hence the latter is not recommended to evaluate hospital efficiency reliably. This study provides relevant information for public health policy makers, hospital managers and researchers, in order to promote the efficiency and improvement of health services.