Purpose This study examines the efficiency dynamics of public health service providers in Colombia between 2010 and 2021. In order to achieve this objective, a data panel is utilized to assess the effectiveness of 841 institutions across three levels of complexity (1, 2 and 3) in providing patient care, taking into account user satisfaction from 2010 to 2021. Design/methodology/approach By employing growth mixture analysis (GMA) and other statistical techniques, we may identify unique efficiency profiles among hospitals with different levels of complexity. Findings The results demonstrate varied efficiency patterns, with certain profiles generally retaining or improving efficiency over time, while others observe fluctuations or reductions. Efficiency outcomes are significantly impacted by factors such as capital investment, operational costs and workforce mix. Efficiency levels can be improved by making strategic investments in capital infrastructure and implementing effective operational cost management. Originality/value Changes in the healthcare market conditions in recent years in Colombia have compelled healthcare providers (IPS) to transform themselves into sustainable organizations.