War Hospital review - you won't save everyone

War Hospital key artwork
Credit: Nacon / Brave Lamb Studio

War Hospital key artwork
Credit: Nacon / Brave Lamb Studio

War Hospital is one of the first new simulator games coming to the latest console and PC generation. Experience the pressures and stress of building up and managing a hospital right near the front lines of WWI. War is unpredictable, unforgiving, and messy, and War Hospital puts you through many such scenarios to ensure an immersive experience.

We'll be taking a look at some of the various aspects of the game and going over the atmosphere, gameplay, level of immersion, and a list of annoyances that overshadow what is an otherwise fun strategy title.

war hospital top down view
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Credit: Brave Lamb Studio

War Hospital is a top-down management game, and you're immediately thrown into a dilapidated base serving as the region's hospital. The game has chosen a realistic but fairly stylized art style that makes the topic of war and death feel real but still maintains a unique style of its own. To be honest, the graphics are nothing to write home about alongside the bunkers that do very little to enhance the visceral nature of one of history's most brutal periods.

Whenever you're over capacity or letting too many people succumb to their ailments, the game will bombard you with a soundtrack with an extremely stressful buildup to put the pressure into perspective. War Hospital also manages to grip you with a sense of dread as things feel like they're continuously snowballing out of control when you're struggling to keep up with the demands of soldiers desperately needing care.

The game is designed to be a blend between survival and strategy, with both taking centre stage one at a time. However, the game shines and is at its most stressful when you're forced to do both. The calm moments are surprisingly quite dull rather than satisfying while the high-stakes scenarios do well to put you in positions where your decisions ultimately decide between life and death.

war hospital all resources in warehouse
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One thing I need to praise War Hospital for is how it manages to be a very accessible game despite being full of various systems and dozens of resources to keep track of. The game felt quite accessible and will feel like this even to people who are completely new to management sims and RTS titles. You can take your time learning the ropes, as starting a new game and getting back up to speed aren't very difficult tasks.

The gameplay consists of running a hospital and all the associated teams. You have your various resources, staff, and patients. The game performs an excellent balancing act with the resource management aspect, where nothing feels too plentiful, and everything that does feel plentiful eventually feels lacking. It doesn't ever let you get too comfortable with letting things run on autopilot.

The primary loop involves scheduling the hospital staff while steadily gathering materials to upgrade your war hospital's capabilities so you can meet the increasingly demanding challenges as war ramps up in the region. Assign your crew to various tasks while ensuring that you keep morale high. This is easier said than done, and you'll often find yourself powerless to save several soldiers, and this can snowball into various issues popping up all at once resulting in a sticky situation for your wartime healthcare.

war hospital scheduling board for hospital
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Credit: Brave Lamb Studio

Your hospital staff consists of surgeons, nurses, medical staff, engineers, and scouts once they're unlocked by playing through the game. Each of them has a unique role to play, and you can't let them get too exhausted or hungry, as your Morale depends on it. Zero morale means game over, so it's the prime resource to keep track of. There's a ton of micromanagement that you need to take care of in order to keep your hospital running like a well-oiled machine.

The game has managed to capture a fine balance between the various resources. Once healed, soldiers can be traded for Morale, Military Drafts or Combat Strength. Each of these resources is essential, and you'll be caught in a tough spot making decisions to prioritise one over the other at all times. The other resources are primarily food and types of medicine, which are simple enough to understand when attempting to rehabilitate soldiers.

Note that there are no difficult settings for War Hospital, so you will get Brave Lamb Studio's very intentional and fairly brutal experience where you must come to terms with the fact that you can't save everyone no matter how hard you try.

war hospital staff management and scheduling
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Credit: Brave Lamb Studio

Your decisions are not instantaneous, meaning your staff will take some time to complete tasks while the conflict is raging on in the background. This might seem minor, but it lends a lot to the game's realism and invokes the feeling of the ongoing struggle under your supervision. The snowball effect mentioned earlier is very real and puts you under a lot of pressure as soon as the slightest mistake starts to spiral out of control.

War Hospital is full of difficult decisions that you need to make every few minutes. Every resource will come at the cost of human life, making the decisions particularly painful and thought-provoking without being preachy or pretentious. The experience speaks for itself.

I also have to praise the upgrade tree here as the methods and medical procedures there all come from the WWI era, making them feel very immersive. Looking at them as "upgrades" through a modern-day lens really puts into perspective how much of a struggle these medical procedures used to be just a century ago.

war hospital decide fate of soldiers
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Credit: Brave Lamb Studio

You also get to choose the fate of soldiers and get an insight into their lives through their individual biographies. These files contain their backstories and photos, allowing you to empathise with them. However, once treated, you can either send them to the frontlines, to the hospital trenches or release them from duty. Each of these decisions carries a resource and moral weight, yet another weight put on your shoulders.

Every decision you make is related to the morale of your hospital in one way or another. This layering and interdependence between every decision make for a very cohesive package that lends itself quite well to a stressful and immersive experience. The game will definitely make you question your own morals. However, there are still some attributes that definitely end up taking away from this solid foundation the game has for itself.

war hospital upgrade tree improvements path
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Credit: Brave Lamb Studio

While there is plenty to praise about War Hospital, there are some shortcomings. For starters, a lot of the various icons display no information if you try hovering over them. A resource management game with so much going on at once should make it as simple as possible to keep track of the game's various considerations without opening up the compendium. While this might seem like a minor complaint, it's a pretty major oversight that should not happen if user experience is kept in mind.

Another issue is the complete lack of auto-save features, which I'd consider standard in the modern gaming industry. I myself lost four hours of game time because I forgot to save the game after a lengthy session of playing.

The camera controls are wonky for the mouse and keyboard, with the keyboard controls making it jump all over the place and the drag and mouse simply doing nothing, which is kind of ridiculous if you think about it. A top-down management game without mouse controls to drag the camera across the map? Speaking of controls, there are no options to bind keys and change control settings for PC, which was quite the hassle.

war hospital soldier biography and profile
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Credit: Brave Lamb Studio

The game performs fine, but one particular bug with looping tips started driving me insane, so I had to turn them off completely. Safe to say, going in blind with no advice in a game like this was not a pleasant experience. Speaking of performance, the game isn't too demanding, but if you play it at 4x speed, the animations themselves become quite choppy. It's not really an ideal experience since most people will be playing with the game sped up.

The gameplay loop is solid but can end up feeling repetitive if you're the type of person who likes to play optimally. The best way of playing War Hospital becomes quite clear, and even if things are randomised, you're bound to play it the same to guarantee the best results. The same goes for the soldiers and their biographies. Every patient you get has a basic biography attached, a picture, and you get to choose their fate.

However, with the German attack mounting, casualties and injuries in the dozens, and the stress of managing your own staff and resources, these individuals all blur into one and you'll find yourself looking at them like resources. On one hand, this is a brilliant allegory for what the experience of war does to our perception of fellow human beings but it's also a failing on the game's part to truly make you care for the individuals involved.

War Hospital succeeds in its mission to have you feeling several conflicting emotions all at once. Most people would come into this game as idealists, hoping to save everyone and be a beacon of hope and support for these soldiers. However, these aspirations are brutally and repeatedly shattered by the experience this game puts you through. In this sense, the game is successful.

Where it fails is the fact that the gameplay loop eventually feels quite repetitive, and the issues with quality-of-life features exacerbate this even further. However, if you're looking for a WWI management experience that will challenge you, then War Hospital can provide you with a pretty authentic experience.

War Hospital
An immersive management game that has players make tough decisions in the middle of a war. Brought down only by the cruel and repetitive nature of its setting and a lack of focus on quality-of-life features.
7 out of 10