War Hospital Review — A Life or Death Management Sim

War Hospital sees you managing life or death during one of the most horrific conflicts in human history.
War Hospital Featured

War Hospital is not what you’d expect. There tends to be one universal commonality in simulation/management games: Your goal, more often than not, is to produce some sort of profit. Be it through managing a nation and building up your military, economy, and industrial sectors or running a small restaurant. There is usually a sense of starting somewhere with very limited resources and gradually improving until you’re raking in bucks. It’s a gratifying feeling, one that can instantly make you feel successful and satisfied when you see that profit margin go up, and since you’re usually dealing with imaginary commercial resources, you don’t feel too invested in failure.

War Hospital takes the genre and flips it with a darker tone. Your resources are now human lives and the means of treating them, and your profit margin is how many lives you can save, the sign of your improvement and growth being your ability to turn away fewer and fewer wounded soldiers from your understaffed, underfunded, and undersupplied war hospital.

Wow. That is quite a step away from my Tobaccoo-Cigar pipeline on Tropico 6, but it’s a welcome take on the genre I was eager to experience. Ironically, I was coming off one of the worst colds I’ve ever had when I played War Hospital, which I think elevated the experience.

War Hospital Surgey
Screenshot: Try Hard Guides

One of the first things you’ll notice about War Hospital is that there is a lot for you to manage (After all, the game is not called “War Medical Tent”). In your frontline hospital, you will manage incoming patients, their surgery, recovering wounded, and burying the dead. There are also engineering projects needed to expand the hospital, train schedules, supply shortages to manage, pharmaceutical production, and the shifts of every doctor and soldier involved in each of these many hospital buildings, which will collapse from exhaustion if not given proper time to rest.

Because of the complexity of the game, War Hospital tends to hold your hand a lot through the lengthy tutorial. While I appreciated this at first, it became kind of annoying after a while when the tutorial messages would continue to pop up after I read them, forcing me to turn my attention away from the task I was working on to do something I felt wasn’t as important at the time. One such popup, which was trying to teach me how to assign my engineers, came because I didn’t have any engineers to assign; I had already figured the mechanic out and had them working on another project. This popup kept coming up until it eventually forced me to reload a save because I couldn’t close it.

If you’re anything like me, managing your employees’ shifts will be the least fun bit of the game, and you’ll probably see a lot of teams collapsing early. I think the game is, in part, designed for this to happen, to incentivize you to grow your hospital and staff. Believe me, once you get that second surgeon, it feels like a true godsend.

War Hospital Treatment
Screenshot: Try Hard Guides

One of the standout and exciting aspects of the management is assigning patients to be operated on. It is more complex than just helping everyone who comes through the door. Every patient has a different severity of their wounds, and your doctors can only work so many hours before needing to rest. It’s up to you to carefully read the profile of every patient that comes through your door, taking into account information such as surgery complexity and operating time, and then compare it to how many working hours your surgeons have on hand. The unfortunate reality is that some patients must be turned away to keep the hospital running, and it’s up to you to decide who lives or dies.

Patients going into surgery often face complications that require you to intervene, giving you a chance to step into the operating room yourself and further make decisions that will impact the lives of your patients. The way the game keeps you interacting with a patient from the moment they step through your door to the moment they leave is fascinating and does more to make you feel like an actual hospital manager than just upgrading buildings would.

Your final interaction with a living patient happens once they recover, where you can decide to send them home for morale, send them to headquarters to requisition more staff, or send them to the trenches to defend the hospital.

War Hospital Recovery
Screenshot: Try Hard Guides

That’s right, the hospital is under constant threat of attack from the German army. As well as managing everything else, you must protect yourself from increasingly difficult attacks by managing the fighting force of soldiers. This is information that affects your decisions back to the operating room, where you must decide if a less risky surgery is worth it if it leaves a soldier incapable of fighting.

The gameplay of War Hospital is solid and may be the best of its kind. I struggle to think of another high-stakes military hospital management game that goes into the level of depth and grueling excitement that War Hospital does.

When it comes to criticisms of the game, my list is fairly light. I’ve already complained about the lengthy tutorials, which, while you can shut them off, I don’t recommend doing so until you’re sure you understand everything.

War Hospital Battle
Screenshot: Try Hard Guides

Managing your staff’s rest time, while necessary for the feeling of fatigue and hopelessness the game gives you, can be confusing and, at times, frustrating, especially when trying to remember who needs a break. Thankfully, if your staff isn’t being worked, they rest automatically, so when in doubt, you can always just stop giving orders for a while.

Finally, the less-than-stellar localization can lead you to do a double or even triple take on some sentences despite the game being readable. Despite the confusion, it’s not the worst translation I’ve seen, and it doesn’t hinder the game severely, even if it’s a bit immersion-breaking.

The Final Word

War Hospital takes some challenging, innovative management sim mechanics and throws them in a tense setting, where your every choice could mean life or death. Try to make the most of a bad situation in this game about running a hospital during one of the worst conflicts in history.


Try Hard Guides was provided with a PC review copy of this game. Find more detailed looks at popular and upcoming titles in the Game Reviews section of our website! War Hospital is available on Steam, Xbox and PlayStation.

Erik Hodges

Erik Hodges

Erik Hodges is a hobby writer and a professional gamer, at least if you asked him. He has been writing fiction for over 12 years and gaming practically since birth, so he knows exactly what to nitpick when dissecting a game's story. When he isn't reviewing games, he's probably playing them.

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