The erection of hospital edifices necessitates building techniques that fulfill the criteria for excellence, economical expenditure, and swift project finalization. One strategy that is commonly utilized is the adoption of precast concrete frameworks, which are seen as effective in enhancing productivity and shortening the period of on-site construction. This research intends to assess how the integration of a precast structural framework influences cost and time efficiency within the Borong Hospital Design and Build Initiative. The study utilized a quantitative descriptive approach by performing a comparative investigation between precast structural design and traditional structural design, focusing on working blueprints, cost projections (RAB), and project timelines. The evaluation centered on primary structural elements, such as columns, beams, and floor slabs, to ascertain the degree of cost savings and time efficiency achieved. The findings demonstrate that the use of precast structures can lead to a decrease in the timeline for structural tasks, as the manufacturing process occurs concurrently with on-site construction activities, enhancing project time efficiency by a total of 46 days, which is equivalent to 20.91%. Moreover, the incorporation of precast structures offers cost advantages due to diminished needs for formwork, labor, and wastage of construction materials, leading to savings of IDR 1,150,515,798.29, representing 5.18% of the overall structural expenditure. Hence, precast structural design can be regarded as a viable option for enhancing the performance of construction endeavors, especially in hospital projects that demand high quality standards and strict deadlines