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Objectives : The purpose of this study is to analyze the differences in financial performance, productivity, and patient care performance between metropolitan and non - metropolitan hospitals and examine the factors affecting profitability of both groups. Methods : The survey period consisted of three years of data that can identify the financial performance of the hospital. The survey subjects were selected from 58 metropolitan hospitals, 87 non - metropolitan hospitals and 147 hospitals. Results : There was a significant difference in stability, activity, cost index, productivity, and patient care performance between the metropolitan and non - metropolitan hospitals, and metropolitan hospitals showed a relatively higher ratio. Conclusions : In the metropolitan and non-metropolitan hospitals, the variables of productivity and cost index increase the profitability. However, if the factors with less influence on the results of the study are applied to the variables of various situations, it may have a great influence on the profitability increase.