Objective To analyze the factors influencing the capacity of public hospitals in response to public health emergency and to propose optimization strategies.

Methods A literature review was conducted using databases including CNKI, Weipu Information, and Wanfang Data to retrieve original data on the influencing factors of the capacity of public hospitals in responding to public health emergency. Grounded theory was employed to construct a framework of influencing factors. The decision-making trial and evaluation laboratory (DEMATEL) method, based on consultations with 35 experts, was utilized to analyze the relationships between these factors and identify key drivers.

Results A total of 82 relevant articles were identified. Open coding analysis yielded 575 statements. Through open, axial, and selective coding, five core categories were established, namely personnel management, hardware and equipment, service quality, institutional management, and cultural environment; while they were further subdivided into 20 main categories (influencing factors). The DEMATEL model identified 13 cause factors and 7 effect factors. Among these, 8 factors exhibited high cause degrees and centrality, serving as driving elements with the most significant impact on the system. These included crisis awareness, emergency preparedness plans, interdepartmental collaboration, linkage mechanisms, early warning systems, policy environment, job training, and emergency supplies.

Conclusions Enhancing the capacity of public hospitals in response to public health emergencies requires improvements in regulatory frameworks, reinforcement of crisis awareness, establishment of robust support systems, and strengthening of interdepartmental collaboration.