head to head
Neither is harder. They score identically on all four axes, so the difference between them is in kind, not degree.

Optimization · Pure Optimization
A small-plot city builder where specialization economics and traffic engineering decide success.

Optimization · Pure Optimization
Comic hospital tycoon optimized by room layouts and staffing.
SimCity (2013) leans Optimization (Pure Optimization); Two Point Hospital leans Optimization (Pure Optimization).
Same score on execution - which means the number cannot separate them. The difference is in what each one asks of you.
SimCity (2013)
Mouse planning; no dexterity demands.
Two Point Hospital
no reflex
Same score on reads - which means the number cannot separate them. The difference is in what each one asks of you.
SimCity (2013)
No opponent; multiplayer regions cooperate.
Two Point Hospital
no adversary
Same score on variance - which means the number cannot separate them. The difference is in what each one asks of you.
SimCity (2013)
Agent simulation quirks behave unpredictably.
Two Point Hospital
patient illness mix
Same score on optimization - which means the number cannot separate them. The difference is in what each one asks of you.
SimCity (2013)
Specialization chains and traffic layouts reward systematic planning.
Two Point Hospital
room layouts, staffing, training
A matching score does not mean a matching test. Two games can both sit at 10 on execution and demand completely different things of you - which is why the reasoning above matters more than the number beside it.