The hospital conducts a wide range of activities and generates a massive amount of effluent daily, especially in hospitals in developing countries. The higher the service density they provide, the larger the amount of wastewater they generate, which contains both infectious and non-infectious contaminants, such as radioactive materials, heavy metals, and pharmaceutical chemicals. This research aimed to identify the factors that influence the decisions to adopt the electrocoagulation (EC) method for hospital wastewater treatment (HWWT) in the regional hospitals under the Ministry of Public Health in Thailand. The Delphi technique was used to identify expert-consensus factors through four rounds of surveys. The final result of this research revealed four factors achieving unanimous consensus: (1) area requirement, (2) operational flexibility, (3) Operational Expenditure, and (4) environmental friendliness. The findings of this research are expected to support efficient decision-making when considering the use of EC treatment systems for hospital wastewater treatment, particularly tailored to the needs of regional hospitals in Thailand.