Importance: This research examines how economic and financial variables affect the capital structure of private hospitals during the pandemic. The aim is to bolster investment strategies and improve the private health system, optimizing financial decision-making in the area of health economics. Methods: We analyzed 40 private hospital companies based in the Region of Murcia, the Valencian Community and the Balearic Islands. The years analyzed were 2019, 2020 and 2021. Due to the low number of companies of this type, their representativeness is high. A descriptive analysis of each variable was conducted, followed by a polynomial regression analysis to develop a predictive model. Results: The analysis indicates a non-linear relationship between ROE and capital structure, with a significant influence of years of hospital activity and legal form. ROA and business size variables have no impact. The model justifies up to 48.39% of the variability and is statistically significant, relating debt-to-asset ratio with ROE, years in operation, and legal form. Implications: The adaptation of financial strategies according to ROE, longevity and legal form, serves as a precedent for private hospitals and their investment decisions in future periods of health crises. It also provides insight for informed decision-making within the sector. Differential value: To date, there is no research on capital structure focused on these three regions during this particular crisis period.