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First of all and contrary to normal toilets, the golden toilets cast an attractiveness area around them which is quite good and helps a lot to keep the environment attractive (it boosts happiness or to be more accurate in the case of patients, it reduces the happiness loss rate).
https://imgur.com/a/27U8Qa4
Of course, for normal toilets you can still achieve a "similar" result with cheaper objects like awards/posters on the walls but it's less efficient because of next difference.
A big difference between the toilets is that normal toilets start to cast a negative attractiveness area around them when maintenance diminishes. At 20% maintenance and below, if there is nothing to increase attractiveness around it, patients using it or moving nearby will get the "Ugly environment" debuff and lose happiness a bit faster. Even at 0% maintenance, the golden toilets don't cast a negative attractiveness area at all. They only stop providing the "attractive environment" buff by themselves at around 35% maintenance.
https://imgur.com/a/sRBCz0H
The most surprising and important difference that I have never seen mentioned anywhere is that golden toilets lose less maintenance than normal toilets per usage ! Normal toilets lose 10% maintenance whenever someone uses them while the golden toilets lose 5% maintenance when someone uses them.
This means Golden toilets are are twice as "durable" and therefore require less attention from janitors... As a side note, they still both love 10% maintenance when an NPC vomit in them but it shouldn't happen that often since NPC usually vomit in bins.
Edit:
Finally, golden toilets also increase room prestige a lot compared to all other items. This makes it easier to have a higher room prestige level. Even though it's not really useful for patients, it's still quite good for employees since they will receive the happiness boost from the prestige while they are in the room.
@RNW - More testing is required to see if there is any "hidden" advantage, but there are already so many advantages it would be surprising.
These things I didn't know yet, and it will be interesting to see the effects of it myself when I pay attention to it.
Very useful info Freiya, thanks! Also I believe the above is related to an indirect improvement in the toilet queues, because of less time wasted by janitors doing maintenance while no one can use them. If there are no other available toilets when janitors do maintenance this problem amplifies itself. Golden toilets help solve this by needing less maintenance, meaning more toilets available at any time and less like to form queues.
Of course queues elsewhere play a role too but here we are examining whether a specific item can help if all other factors remain equal. It seems golden toilets can help, and their cost is minimal for 3-star hospitals (sometimes you might have to delay upgrading until then).
If anyone notices anything else worth investigating, please post!
The decay speed of the toilet need seems to be impacted by thirst, hunger and toilet need itself, I am not sure there are other factors (except employee's trait "weak bladder"). When an employee is hungry and thirsty and have the toilets need at around 35%, the decay of the toilet need can become very very very slow. Not sure what's the exact formula behind it...
For me this is totally worth the cost. But I would not upgrade too early (there is no need anyway) since there are more important needs early on. Later on, definitely upgrade, it is a one-time cost with a permanent effect on the map.