Purpose: Evidence-Based Design (EBD) improves healthcare environments by linking physical design elements to performance outcomes. However, international frameworks cannot be directly applied to Korea due to differences in healthcare systems and institutional contexts. This study aims to develop a Korea-specific EBD data framework and construct an evidence database for application in Korean healthcare facilities. Methods: The research proceeded in three phases. First, international EBD frameworks (Pebble Project, DQI Health, EBD Glossary) and Korea’s healthcare accreditation standards were reviewed to identify environmental variables (independent) and performance outcomes (dependent), reflecting domestic contexts. Second, a systematic literature search was conducted using 98 spatial-design-related keywords in the Korea Citation Index (KCI) and PubMed, targeting peer-reviewed articles published between 2007 and 2022. From 66,215 retrieved articles, 1,669 were screened and 283 were selected for full analysis, categorized as direct evidence (empirical linkage between environment and outcomes) or indirect evidence (design-focused without direct linkage). Third, the framework was refined based on analysis and expert consultation. Results: Among the 283 studies, 80 provided direct evidence and 203 indirect. Planning and unit space were the most frequently evidenced elements; clinical outcomes and patient satisfaction were the primary performance outcomes. Research on external environments and medical errors was limited. Implications: This is the first EBD database tailored to Korea, offering structured guidance for education, research, design, and policy. The findings can inform policy standards, guide architectural curriculum development, and support data-driven decisions in healthcare facility design practice. A five-year roadmap (2025–2029) supports its expansion and integration, promoting improved healthcare design quality and outcomes.