Renewal Strategies for Older Hospital-Adjacent Communities Based on Residential Satisfaction: A Case Study of Xiangya Hospital

Since 2019, China has been promoting the renovation of old urban residential areas built in 2000 or earlier. However, older communities surrounding large urban hospitals face unique challenges, including deteriorating infrastructure, complex social dynamics, and conflicts between tenants and residents. This study focuses on old communities near Xiangya Hospital in Changsha, Hunan Province, employing questionnaire surveys to analyze residential satisfaction and demands across three dimensions: housing spaces, community public spaces, and social relations. Using multilevel linear regression, structural equation modeling, and moderation effect analysis, this research systematically investigates influencing factors and group heterogeneity. The findings reveal that community greening, recreational facilities, and property management are core drivers of residential satisfaction, while social relationships and public spaces play critical mediating roles. Distinct group-specific needs emerged: elderly residents prioritized greening, security, and property management responsiveness; medical students emphasized sound insulation and tenant management; and patients and their families heavily emphasized ventilation and lighting, hygienic conditions, and infrastructure. To address these issues, the study proposes an integrated renewal strategy emphasizing the integration of physical upgrades and soft governance. The findings provide theoretical and practical insights for the systematic renewal of similar older hospital-adjacent communities.