Hospitals make increasingly more use of social media. The basic hypothesis of this study is that the more developed the health care services of a country are, the higher the communicative activity of its hospitals will be on social media. Moreover, the highest presence and activity on social media will be associated with the most prestigious hospitals in countries with fewer economic resources. The presence of the most prestigious hospitals in both Colombia and Spain on Facebook, Twitter, YouTube and Instagram are analyzed in this paper to either refute or to accept these hypotheses. Both countries have similar populations, but their economic and health care services differ greatly. The degree of activity on these platforms, the participation of Internet users, and the reputation of the hospitals are also studied. In total, 165 profiles are analyzed. The results are processed in a statistical software program and various tests establish whether there are significant relations. It was observed that the level of health-care services of the country was not correlated with the presence and activity of the hospitals on social media, nor with the interaction of Internet users. In addition, a correlation between social-media presence and reputation was detected in the country with the most developed health-care services (Spain). In conclusion, the fact that a country has more health-care resources neither implies that its hospitals have either a greater presence or are more active on social media, nor that the public interact more with those hospitals.