<![CDATA[In recent decades, Green Hospitals have been the subject of numerous studies, yet conceptual fragmentation and ambiguity persist. Thus, the purpose of this study is to address the fragmentation and conceptual ambiguity in green hospital literature by a hybrid approach that integrates a systematic literature review (SLR) and bibliometric analysis. Unlike prior studies, which are predominantly descriptive, this study provides a structured synthesis, identifies theoretical gaps, and develops an integrative framework. A total of 169 Scopus-indexed articles between 2011 and 2025 were systematically identified using an expanded Boolean search strategy ("Green Hospital" OR “sustainable hospital” OR “green healthcare” OR “eco-friendly hospital”) and analyzed following PRISMA guidelines. Bibliometric analysis was conducted using VOSviewer to map intellectual structure, collaboration networks, and thematic evolution. The study findings indicate that the existing study is heavily concentrated on environmental and infrastructure dimensions, while behavioral, governance, and policy aspects remain underexplored. The study also identifies geographic concentration and potential database bias in the global distribution of the study. Importantly, the study develops an integrated Green Hospital Sustainability Framework (IGHSF) based on an inductive thematic approach. This study contributes to the literature by improving methodological rigor in green hospital studies through a hybrid SLR-bibliometric approach, advancing theoretical understanding of sustainability integration in healthcare systems, and providing actionable insights for policymakers and healthcare managers in implementing sustainable hospital practices.]]>
