http://web.archive.org/web/20210815204141/http://images.pcgamingwiki.com/a/a0/GOG.com_DOSBox_Configurator_v2.png sry for my b.eng and misprints. I hope ypu get what i say here. look at your default conf, my conf file. and reading comments try to edit your ones (not just copy mine as is).
As you say, you already know few of that steps for game tweaking. conf file edits is last one and same simple. more text here, less real actions actually.
GOGDOSBOXLaucnher have probably all options needed to change, except cycles tweaks. But GOG used differ lacunhers in each release, forgot tu put needed options, fix that - and forgot again. Warcraft 1 is example when even after 'hotfix' ('default options was changed and missing settings re-added to layncher') - they still forgot to make it similar to others launchers and use outdated one.
Should be output, fulslcreen\windowed, resolution - just in goglauncher. Start game from it, if desktop link lead to another simles exe file.
PCGW have only one fix mentioned and it is wrong one not needed (just unplug smartphones or wireless headsets, use USB one or PC-specific audiojack ones).
GOG version is RIP, no Windows version. That mean it can be launched only from DOS emulators. If you have normal CD version, you can try better Win-executable version. If there is issues to launch it - try WineD3D or any else DirectX (ddraw\d3d) wrappers. They will work only for Windows executable missing in most GOG's DOS games releases.
Original and most re-editions of game on CD use x16 installer that is require additional tweakig to use on x64 OS. otvdm or x16-x32 installshield\innosetup updated libraries. CD content should be copied to D:\CD\HOSP\ or something like that - and tweaked files copied above.
Or just copy HOSP and exe\dll files from cd to GOG version without overriting GOG files - add missing ones.4
There is fan-made open-source remkae CorsixTH. As any remakes - be careful with it. it have changed a lot of mechanics, although it almsot impelment everything now - something work brokenly (earthquakes is too much often cause of new random-generator feature missing that earthquakes rate is pre-set on map itself and multiply it as result - last missions in campiagn on CorsixTH is unplayable due to earthquakes)/
For old CD version you should also install official Theme Hospital patch.