Introduction In line with China’s “Dual Carbon” goals, achieving a green transformation of the healthcare system is imperative. This study aims to identify the factors driving energy use and to explore energy-saving strategies in large tertiary general hospitals across various architectural climate zones, thereby providing insights for sustainable development within the healthcare sector. Methods Adopting a research design of “quantitative as the main approach, supplemented by qualitative” methods, we integrated data analysis, field surveys, and questionnaires. The study examined 12 tertiary general hospitals in Jiangsu Province from 2022 to 2023, collecting on-site building data and energy management information. Data analysis combined Spearman correlation analysis with findings from the questionnaire surveys. Results The analysis revealed that hospitals in different climate zones exhibited similar quarterly patterns of energy use, but the key correlative factors varied significantly. Specifically, energy consumption in cold zones was primarily affected by operational scale, whereas in hot-summer-cold-winter zones, it was influenced by both hospital size and external temperature. Field surveys indicated that although all sampled hospitals had implemented some energy-saving technologies and management systems, none had installed real-time online energy monitoring systems. Conclusion To establish efficient, low-carbon, and resilient hospitals, tailored strategies are recommended. For cold zones, the focus should be on optimizing energy structures, building design, and facility layout. For hot-summer-cold-winter zones, improving building insulation is crucial. Furthermore, accelerating investment in intelligent carbon-monitoring systems, managing energy hardware upgrades at the source, and enhancing staff energy-saving awareness are essential steps forward.
Ni et al. (2026) studied this question.