Objective To explore feasible strategies to address inadequate strategic coordination, low publicity efficiency, single-dimensional assessment, and lack of effect tracking in talent recruitment at prefecture-level tertiary public hospitals, so as to improve hospital recruitment efficiency. Methods The key indicators of talent recruitment at Guang’an People’s Hospital from 2019 to 2025 were selected. According to whether the four-dimensional collaborative recruitment system featuring “strategic alignment + multi-channel publicity + comprehensive assessment + evaluation guidance” was adopted, the period of 2019–2021 was defined as the pre-intervention group and 2022–2025 as the post-intervention group. The key recruitment indicators before and after intervention were compared, and comparisons were also conducted with two other prefecture-level tertiary hospitals in Sichuan Province during the same period. A difference-in-differences model was employed to evaluate the net effect of the practical efficacy of the four-dimensional collaborative recruitment system. Results After the intervention, the talent application rate [(2.080±0.208)% vs. (5.740±1.998)%], recruitment completion rate [(0.667±0.025)% vs. (0.950±0.029)%], new employee retention rate [(0.853±0.038)% vs. (0.945±0.013)%], employing department satisfaction [(0.827±0.050)% vs. (0.950±0.032)%], and new employee satisfaction [(0.807±0.059)% vs. (0.945±0.040)%] in Guang’an People’s Hospital were all higher than those before the intervention (P<0.05). Furthermore, the talent application rate, recruitment completion rate and new employee retention rate were higher than those of two prefecture-level tertiary hospitals in Sichuan Province during the same period (P<0.05). Difference-in-differences model showed that the four-dimensionalcollaborative recruitment system exerted positive effects on the talent application rate, recruitment completion rate and new employee retention rate (P<0.05). Conclusions The four-dimensional collaborative recruitment system has achieved a deep alignment between talent recruitment and hospital development strategies through optimizing recruitment management throughout the entire process. It has effectively enhanced recruitment efficiency and talent stability, providing a replicable and scalable practical path for municipal public hospitals to strengthen talent team building and promote high-quality development.