Purpose The purpose of this study is to examine what expectations and mediating factors are needed as variables necessary for the intention to use logistics hollowing out, and at the same time, what factors strengthen medical SCM competitiveness. In order to develop competitive competency variables for medical institutions that affect the intention to use logistics cavitation, we would like to examine the key success factors applying AHP model analysis. Design/methodology/approach For AMOS analysis, we conducted an online survey of four universities and analyzed 212 samples. The analysis method used SPSS, and AMOS. We proposed several factors categorized as reliability, SCM advance, and scalability. Findings The results showed that all proposed variables (competitive competencies for HSCM, expected performance) had a significant impact on intention of physical distribution cooperation. According to the measurement methods proposed in this study, key success factors for strengthening the capacity of HSCM can increase the need for physical distribution cooperation through expected performance.