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Introduction: Hospital services are considered to be the principal factors which contribute to increasing healthcare costs in many countries; therefore, considering health economic issues and identifying background factors affecting them, is one of the top priorities of health care management. This study aimed to determine factors affecting the culture of health economics from the perspectives of health services providers. Methods: In this ethnography study, data were collected through interviews, observations and cultural artifacts in two major hospitals affiliated with Mashhad University of Medical Sciences. Semi-structured interviews were conducted with 35 key informants among clinical managers, and other health professionals. Data analysis was performed using Miles and Huberman methods. To determine the rigor of data, Guba and Lincoln’s criteria were used. Results: Data was conceptualized in the two major domains of resources, i.e., management and healthcare quality. Conscientiousness in the workplace, knowledge and experience, facilities and equipment, motivations and management’s supervision were the main factors affecting the areas under study. Conscientiousness in the workplace was turned out to be the most important factor affecting the culture in the study group and was influenced by knowledge and clinical experience and motivational factors in the workplace. Conclusions: Excessive work pressure, lack of motivation and knowledge regarding the maintenance of equipment, resource constraints and weak supervision were the factors affecting the individual’s productivity which is mainly under the influence of conscientiousness and commitment in the workplace. Therefore, it is proposed to take measures to foster Conscientiousness and commitment of professional staff in the workplace, pay greater attention to motivational factors, modify the system of funding hospitals and organize training courses related to health economics and inventory management.