Israel's military said it struck dozens of militant targets including tunnels over the previous day, and the health ministry in Hamas-run Gaza reported at least 62 more deaths over a similar period.
The United States' criticism of Israeli Prime Minister Benjamin Netanyahu has mounted over Gaza's civilian death toll, dire food shortages, and Israeli plans to push its ground offensive against Hamas militants into Rafah.
Gaza's far-southern city is crowded with displaced civilians and world leaders have warned against a Rafah offensive.
They fear it would worsen a catastrophic humanitarian situation for the Palestinian territory's 2.4 million residents, many of whom are sheltering in Rafah along the Egyptian border.
The United Nations reported late Wednesday that famine "is ever closer to becoming a reality in northern Gaza," and said the territory's health system is collapsing "due to ongoing hostilities and access constraints".
Bombardment and fighting have not eased despite a binding UN Security Council resolution passed on Monday demanding an "immediate ceasefire" in Gaza and the release of hostages held by militants.
Netanyahu had scrapped an Israeli delegation's visit called by Washington to discuss the Rafah plan -- a protest after the United States had abstained from voting on the UN ceasefire resolution, allowing it to pass.
Air strike on hospital
Israel's government has since backtracked. White House spokeswoman Karine Jean-Pierre said Israel had agreed "to reschedule the meeting dedicated to Rafah".
US officials say they plan to present Israel with an alternative for Rafah, focused on striking Hamas targets while limiting the civilian toll.
Even without a ground invasion, Rafah is under regular bombardment that on Wednesday left the city's al-Kuwaiti Hospital coping with the wounded and the dead.
A motorcycle cart roared up with a man lying motionless in the back, part of his pants soaked with blood.
The war began with Hamas's unprecedented October 7 attack that resulted in about 1,160 deaths in Israel, mostly civilians, according to an AFP tally of Israeli official figures.
The militants also took about 250 hostages. After an earlier truce and hostage release deal, Israel says about 130 captives remain in Gaza, including 34 presumed dead.
Israel's retaliatory campaign, aiming to destroy Hamas, has killed at least 32,552 people, most of them women and children, according to the latest toll issued Thursday by the health ministry in Hamas-run Gaza.
Israel has launched raids on and near several Gaza hospitals since the war began, saying fighters have used them as bases. Palestinian militants deny such accusations.
Troops began raiding Al-Shifa hospital in Gaza City early last week, and on Wednesday night carried out an air strike "while avoiding harm to civilians, patients and medical teams," the army said on Thursday.
It said the air strike came after militants fired at troops "from within and outside" the hospital's emergency ward over recent days.
An earlier Israeli raid on Al-Shifa last November sparked an international outcry.
Army says hundreds killed
The UN has reported "intensive exchanges of fire between the Israeli military and armed Palestinians". It cited the health ministry as saying the army has confined Al-Shifa medical staff and patients to one building, not allowing them to leave.
Israel's army said troops had evacuated civilians, patients and staff "to alternative medical facilities" it set up.
The army says it has killed around 200 militants in the Al-Shifa area since its operation began, a toll AFP could not independently verify.
Dozens more have been killed in the al-Amal area of Khan Yunis, the embattled southern city just north of Rafah, the army said.
Al-Amal hospital "has ceased to function completely", the Palestine Red Crescent said earlier this week, following the evacuation of civilians from the medical centre.
Israeli tanks and armoured vehicles have also massed around another Khan Yunis facility, Nasser Hospital, the health ministry said, adding that shots were fired but no raid had begun.
Israel denies it is blocking aid trucks but only around 150 vehicles a day are entering the Gaza Strip, compared with at least 500 before the war, according to UNRWA, the UN agency for Palestinian refugees.
With limited ground access, several nations have begun aid airdrops, and a sea corridor from Cyprus has delivered its first cargo of food.
UN agencies said these are no substitute for land deliveries.
Desperate crowds have rushed towards sustenance drifting down on parachutes, and Hamas on Tuesday said 18 people drowned or died in stampedes trying to recover airdropped aid.
Talks in Qatar towards a new truce and hostage release deal, involving US and Egyptian mediators, have brought no result halfway through the Muslim holy month of Ramadan.
Military aid
US criticism has mounted but President Joe Biden has made clear he will not use his key point of leverage -- cutting US military assistance to Israel, which amounts to billions of dollars.
Netanyahu, who leads a coalition including religious and ultra-nationalist parties, faces ongoing protests over his failure to bring home all of the hostages.
Alongside the bloodiest-ever Gaza war, violence has surged in the Israeli-occupied West Bank, where medics and the army said three people were wounded in a gun attack Thursday that targeted a school bus.
The war has raised fears of wider regional conflict, particularly along the Israeli-Lebanon border.
Israeli first responders said they pronounced a man dead in an Israeli border town, after Hezbollah rocket fire followed an Israeli strike on what its military called a "military compound" in southern Lebanon.
Both Hezbollah and Hamas are backed by Iran, Israel's arch enemy.
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