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Abstract Health institutions try to develop strategies to meet the healthcare needs of the community effectively and efficiently, but they also endeavor to preserve their place in the market. However, an accurate analysis and understanding of environmental factors and establishing feedback channels are essential to be able to develop these strategies. In addition, by identifying environmental factors, health institutions can determine their weaknesses and strengths to eliminate the factors that may pose a threat and develop new opportunities. The purpose of this study is to examine and classification of the external environmental factors affecting health institutions. We base our discussion of the external environmental factors on Lynch’s classification of these factors, namely, political, economic, socio-cultural, technological, and legal environmental factors. Furthermore, we discuss the concept of environmental uncertainty, which is very important for health institutions, from Duncan's point of view.