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Objectives : This study explored ways to identify factors that have competitive advantages and achieve high performance by investigating the influence of competence and competitive strategy on the performance and moderating effect of the business environment within special hospitals. Methods : A total of 80 specialized hospitals participated in the study. A multiple regression analysis was carried out by configuring sub-factors for each factor, and a hierarchical regression analysis was conducted with interaction terms as independent variables. Results : Among the competence factors of special hospitals, the competence of hospital staff and business management had a significantly positive (+) effect on the internal performance, and the competence of the marketing management had a significantly positive (+) effect on the external performance. Conclusions : The findings of this study suggest that in the rapidly changing health care environment, special hospitals should select and focus on competitive strategies and competency factors required to ensure competitiveness and achieve high performance, and based on this, need to seek integrated strategic management measures.