This paper proposes a solar organic Rankine cycle integrated cascade refrigeration system to meet a hospital's heating, cooling (each in two temperature levels) and electricity demands. The system is analyzed from energy, exergy and exergoeconomic point of view. Energy and exergy efficiency of the system calculated 89.39% and 8.70%, respectively. Exergy destruction rates of the system components are carried out and results reveal that the solar collector is the main source of irreversibility. The value of exergoeconomic factor for total system shows that the capital investment cost is more than the cost of exergy destruction. Collector is the main component from exergoeconomic point of view. The effect of ORC working fluid change, collector type, solar irradiation and ambient temperature are investigated. Cyclohexane from energy and exergy point of view and octane from exergoeconomic point of view are more efficient. The system with parabolic through collector indicates better results compared to the use of linear Fresnel reflector and parabolic dish collector. Increasing solar irradiation causes reduction in solar field area, energy and exergy efficiencies and total cost of the system. Increasing ambient temperature reduces solar field area and exergy efficiency, and improves thermal efficiency and the total cost of the system. (C) 2020 Elsevier Ltd. All rights reserved.