A review of hospital seismic resilience enhancement strategies and technologies: State of the art, challenges, and future

Hospitals, as the backbone of post-earthquake emergency response systems, exhibit functional complexity and critical importance far beyond that of typical buildings and must demonstrate superior operational continuity and reliability. While developing resilient cities has become a strategic imperative for societal stability and sustainable development, and preliminary frameworks for assessing hospital seismic resilience have been proposed, there is still a lack of clearly defined, scientifically grounded technical pathways for enhancing hospital seismic resilience. This study summarizes the functional characteristics, seismic damage, and function quantification of hospital buildings, reviews past research on seismic retrofit technologies applied in hospital buildings, and proposes an enhancement-oriented framework integrating structural, nonstructural, and organizational strategies. The functions of hospitals are categorized as physical dimension, clinical dimension, and organizational dimension in this paper. Based on the concept of seismic resilience, hospital seismic resilience enhancement should consider the comprehensive demands of “resource-service-management” and integrates mechanism-based technology selection, rapid prediction models, multi-objective optimization balancing cost-effectiveness and operational functionality, and adaptive management strategies. This study advances the field from passive assessment toward proactive enhancement, bridging the information and coordination gaps among governments, users, and practitioners, and providing a technically actionable foundation for future hospital seismic resilience research and application.