The renovation and expansion of county-level hospitals is a key step in enhancing regional medical service capacity. To address challenges such as building aging, process redundancy, and resource allocation imbalances in the process, there is an urgent need to establish a scientific and comprehensive evaluation system to support decision-making. Based on medical process flows, this paper applies the WSR (Wuli-Shili-Renli) systems methodology to construct a comprehensive evaluation system consisting of three dimensions and fifteen indicators. By combining the G1 order relation analysis method with the C-OWA operator for combined weighting, and based on expert survey data, the weights of each indicator are comprehensively determined. The model is subsequently validated through testing and case studies. The research shows that: 1) Among the key indicators, patient satisfaction and community feedback, the rationality of medical functional unit layout, and the elastic expansion capacity of building space rank as the top three in terms of relative weight; 2) The constructed model exhibits strong stability, with an average robustness index of 95.28%; 3) The renovation and expansion of county-level hospitals should prioritize compliance in functional layout, enhancement of emergency capacity, and optimization of patient services, while specifically strengthening logistics automation and inter-departmental coordination to avoid functional redundancy and improve overall cost-effectiveness.