Strategic decision-making is a vital process within organizations due to the multiple variables involved, the resources at stake, and the impact in the medium and long term. These aspects acquire greater relevance in today's complex and highly dynamic healthcare industry, in which strategic decisions must be effective and competitive in order for institutions to survive. The main purpose of this research is to determine the influence of contextual factors on the rationality of the process of strategic decision-making in high-complexity healthcare providers (IPS), through an analysis that integrates the different perspectives identified in the literature: strategic choice (characteristics of the decision-maker), environmental determinism (environmental characteristics), company characteristics, and specific decision characteristics. Given the multidimensional nature of the phenomenon to be studied and in order to obtain more information that allows for the explanation of complexity and the deepening of understanding, a mixed-method research was conducted using a sequential explanatory design. The first chapter will define the problem and establish the research questions. The second chapter will present the conceptual foundations as well as the investigative precedents from which hypotheses are proposed. The third chapter presents the research objectives. The fourth chapter describes the aspects related to the method used to develop the research, such as design, participants, instruments, and procedures. The fifth chapter presents the analysis of results for each of the hypotheses tested, as well as the results of the qualitative analysis. The sixth chapter presents the discussion and conclusions of the results obtained based on the conceptual and empirical referents considered. Finally, in the seventh chapter, the contributions, limitations, and recommendations for future research are presented. The results show that the rationality of the process of strategic decision-making in healthcare organizations is determined by the interaction of different contextual factors. Likewise, the realization of predominantly analytical processes in healthcare organizations was evidenced, characterized by a wide search and analysis of information, the use of quantitative techniques, and the focus on relevant information.
