Theme Hospital

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Theme Hospital
Theme Hospital.front cover.jpg
Developer(s) Bullfrog Productions (PC)
Krisalis Software (PS)
Publisher(s) Electronic Arts
Composer(s) Tony Cox
Russell Shaw
Platform(s) MS-DOS, PlayStation
Release date(s) MS-DOS
  • NA 31 March 1997
  • EU 4 February 1998
EU 199802February 1998
NA 1998033131 March 1998
JP 1998061818 June 1998
PAL 31 January 2008 (PSN)
JP 28 October 2009 (PSN)
NA 31 August 2010 (PSN)
Genre(s) Business simulation
Mode(s) Single-player, multiplayer

Theme Hospital is a business simulation game developed by Bullfrog Productions and published by Electronic Arts in 1997, in which the player designs and operates a hospital. Like most of Bullfrog's games, Theme Hospital is permeated by an eccentric sense of humour. The game is the thematic successor to Theme Park, a game also produced by Bullfrog. The game was a massive commercial success, selling over 4 million copies worldwide.

General information[edit]

The game's campaign sees the player moving from one hospital to another, where within each the player is required to build an environment which will attract patients with comical complaints, illnesses, emergencies, and diseases, and then treat them while tending to their needs. The game has a somewhat dark sense of humour, which is similar to that of Theme Park in many ways (such as in terms of deaths). While the player has no direct control over the patients who wander the hospital, they do however have some influence over whether to evict them from the hospital (whether they are close to death or being a nuisance) or determining what to do with them when given a choice by the hospital's staff; the player can pick up any staff member in the building and move them to a different area (whether to reassign some to another room, send them to get rest), and also fire them if they argue about pay or are no longer required. The player may also force patients into taking a chance at a possible cure for their suspected disease, at the risk of killing the patient (this is useful, for example, if a patient is about to die but has already completed enough diagnostics requirements to identify the kind of disease the patient is suffering from) and rearrange the queue of each of the rooms in the hospital (useful for moving dying patients to the front of the queue so they can receive treatment first, or move those forward who need to be diagnosed more).

Each level consists of an empty hospital to plan and design with various rooms and facilities (which are added to by research and later levels), with set goals in the fields of financial attainment, hospital reputation, patients cured, percent of patients cured, and hospital value. Holding negative funds or allowing sufficient patients to die will bring about losing requirements. When the goals have been met the player has the option to move on to a new, more elaborate hospital with tougher winning conditions and more diseases present, or stick with their current one until they are ready to move; the final level of the game has everything available, and if completed, finishes the campaign.

During development, the game was to feature real diseases that would be researched and cured, but before release, the game developers chose to change this around and instead replaced them with fictional comedy afflictions; some things like surgery, x-ray, cardiography and psychiatry still remain as connection to real methods of diagnosis and treatment.


The game revolves around the player designing a hospital from scratch, where they must set out building up rooms (or facilities) in a hospital, and hiring doctors, nurses, handymen and receptionists to operate it. Rooms are built by placing down a blueprint, assigning the location of doors and windows, and then placing down furniture (each room has needed items, but can have more added to it); the bigger the room, the more windows it has, and the more equipped it is, the happier the staff member will be in it. In addition to rooms, the player may also set up items in the open corridor spaces provided, including drink machines, benches, plants, fire extinguishers, and reception desks (the latter is needed to assign patients to a GP's office). Rooms can be edited at any time to change them around, or remove them at any time. In addition, the player may adjust the temperature given out by the radiators in their hospital, and even purchase land to expand their hospital into, providing more space for additional rooms.

Some rooms are fundamentally required for the running of the hospital and to ensure a good start for it, such as GP's offices (to start and finish the diagnosis process), Staff Rooms (the more items dedicated to rest, the quicker staff will recover), and Toilets (patients who spend a good amount of time in the hospital will need to go here), while others provide aid in further diagnosis or in giving treatment. Most rooms provided have machinery which has to be maintained; if they get overused and neglected for a long time, they may explode, destroying a room (which then can't be removed) and killing any patients & staff within them. To avoid this, players can have the equipment repaired, or replaced (at a cost).

Rooms are divided into 4 categories: Diagnosis, Treatment, Clinics, and Facilities. They function as follows:

  • Diagnosis - Patients are checked out by these rooms to determine their illness. GP Office's begin and end the process, and using more of different types of rooms aids in discovering a patient's illness more efficiently.
  • Treatment - These rooms provide treatment to patients who suffer from illness, an internal body problem or a mental illness. Such rooms become needed in the long-term running of a hospital (both the Ward and Psychiatric both cover this category and Diagnosis).
  • Clinics - Special rooms to deal with more visible (and comical diseases), such as "Bloaty Head", "Slack Tongue", and "Fractured Bones". These rooms require constant attention by the hospital's staff to keep them well-maintained.
  • Facilities - Important rooms dedicated to resting staff, training them, researching improvements, cures, new equipment and such like, and providing a place for patients go to the toilet.

Patients are attracted to the hospital, in part, by the reputation of the hospital and the cost of treatment there. They arrive with a number of amusing fictional illnesses which must be diagnosed and cured to earn money and achieve targets set by the game. Rooms and equipment to treat fictional and comical diseases, must be researched first before they can be placed in the hospital, while other conditions (like "Heaped Piles", "Uncommon Cold" and "The Squits") can have research done to improve the efficiency of its cure provided by the pharmacy. Patients also require their needs to be looked after, including warmth and drink, and placing down plants to help them feel comfortable. Icons above their head are a good indicator of what they are thinking about, in terms of your hospital. Patients can die, if they are treated to within time, or a treatment does not cure them.

During the course of a level, the player is usually faced with various events, most of which are brought to the players attention by the hospital announcer and/or faxes:

  • Staff Demand - Players are tasked to deal with an upset staff member, by either giving a bonus/pay rise, or firing them.
  • VIP Visit - A VIP wishes to view the hospital. Players could fob them off with excuses (too many times, and the VIP comes), or let them come over and check it out. A good visit nets cash, and a possible reputation bonus (if they liked what they saw), while a bad visit can do the reverse.
  • Boiler Breakdown - The hospital's boiler breaks down, leading to the hospital becoming quite hot or cold until it is fixed.
  • Patient Choice - A patient can have two things happen to them; either all methods of current diagnosis have been used to no avail, the patient has been identified with a disease but treatment is unavailable or the patient is suspected of having a disease to a certain percentage. Players can chose to either send them home, or send them to the research department, in all cases, or decide on the following as the third option:
    • Take a chance on a possible cure (Suspected Disease)
    • Wait in hospital for new rooms to be built (More Diagnosis/Identified Disease)
  • Emergency - The player can chose to take on a medical emergency or refuse it. If they chose to do so, patients arrive at the hospital's helipad, and must be treated within a time limit. Patients have a flashing blue-light icon above their head, and head to the appropriate room for their treatment. If the player can treat many or all before time runs out, they can receive a cash bonus (emergencies treated can be cured or killed, and can add cash and raise/lower the hospital reputation, like ordinary patients).
  • Earthquake - The hospital is hit by an earthquake, which damages all equipment within. Sometimes a tremor hits to warn of one incoming, allowing a players to prepare for it.
  • Epidemic - An epidemic (not available on the EU PlayStation version) is discovered in the hospital by staff, who have found an infectious disease. Players can chose to declare one (at the cost of being hit with a fine and a reputation loss), or cover it up. To cover it up, the player must have infected patients quickly vaccinated before they can pass it on to other patients, and then be given treatment, within a time limit, needing any nurse not assigned to a room to do the job (patients have to be marked by the player) to do the vaccinating. If an infected patient leaves or time runs out, a member of the Ministry of Health is sent to check it out. If the player failed to contain it and deal with it, a severe fine and reputation loss is issued (although this is glitched in some versions of the game and sometimes fine the players less if they try to cover up the epidemic), but if the cover up was successful and nothing is found, the player is compensated for the "lies" spread about it, and gains a reputation bonus.

At the end of each year, the player can be presented with several awards based on their performance and management of their hospital. These awards also provides bonuses like additional cash or increased reputation, or penalise the player by deducting cash and lowering reputation. If the player does badly, however, he/she can lose the game, with the game ending with a CGI full motion video. If the player achieves all goals, they are offered a chance to move on to the next level.


The success of any hospital lies in hiring well-trained staff. Staff are separated into four categories of expertise: Doctor, Nurse, Handyman, and Receptionist:

  • Doctors usually demand higher wages than the other three occupations, and also serve a much larger role; they can diagnose and heal most illnesses, they can research new illnesses and equipment, and they can train other doctors. Doctors can specialize in three major (and mostly needed) skills - Psychiatry, Surgery or Research. A doctor can have one or any combination of the three. Doctors also have ranks - Junior (low wage but low experience), Doctor (average experience and wages), and Consultant (high wage, but high experience; they also move faster). Consultant-ranked doctors not only can be the best in diagnosing and treating diseases, they can also train other doctors of lower ranks in a Training Room, and, if they have any of the three skills on them, can also pass these on to those they train.
  • Nurses run the Pharmacy, the room for Orthopedic casts called the fracture clinic and the hospital ward, as well as being responsible for vaccinations during an epidemic. Their experience determines their wages and how speedy they are.
  • Handymen clean the hospital of any messes made by patients, repair machinery, and water the plants. Their experience determines wages and speed.
  • Receptionists handle the Reception Desk, staying there, and mainly assign patients to an available GP's Office.

All staff (with the exception of the receptionists) are affected by both tiredness and warmth, which must be cared for if the staff are to remain content. Use of staff rooms allows staff to be rested, which can be furnished with a number of relaxing and entertaining devices. Placing a suitable number of radiators in rooms allows staff to be kept warm. Also, doctors and nurses enjoy working in rooms that are nicely furnished, big and have a good number of windows. Having the staff overworked often results in the staff demanding a raise and threatening to quit, but in some cases the staff may go crazy instead, although this has no known ill effect in the game.


Micromanagement is heavily used in Theme Hospital, and it can influence both the hospital's efficiency and its reputation. The player must arrange and furnish the rooms to minimize the time required for the doctors to perform their tasks and satisfy the needs of their patients. These needs include a comfortable temperature (neither too hot nor too cold), a clean environment, benches to sit on, and access to drinks and toilets. Furthermore, the player can manually pick up members of the staff and drop them where their intervention is needed (e.g. place a doctor in a room left unattended to visit a patient, or a caretaker over a vomit pool to clear it up), as happens in Dungeon Keeper. With no player intervention tasks are completed much more slowly, since in many levels the staff members have to travel from one end of the hospital to another. The player can also advance a patient in a queue for a room or dismiss them, in order to avoid a death in their hospital, which negatively affects the hospital's reputation and reduces the number of end-of-year awards.

Economic management is also important: the player can change the price for the treatment in all the rooms, balancing a low reputation with cheap prices to gain visitors or quickly raising money while maintaining a consistent number of visits due to high reputation. A common tactic is also to place benches and radiators next to one another, in order to make the patients feel too hot and buy expensive drinks from the vending machines.

Networked game[edit]

The last official patch from EA for the game (Beta 5 patch) enables a network game option for the PC version of the game. The game supports 3 different networking methods: Serial Cable, Modem, and IPX/SPX network gaming. In theory the first two options allow for two players to compete in building the best hospital while competing against two computer-controlled hospitals, while the IPX/SPX network gaming allows up to four players to compete against each other on a network for the best hospital.

Multiplayer compatibility[edit]

The last official patch was version 1.01 and this allows multiplayer over DirectPlay IPX as well as serial, modem and IPX.

Other versions[edit]

Open source clones[edit]

Various attempts have been made to develop an open source game engine based on the original Theme Hospital data files in the version.

Format specification wiki[edit]

Through the means of reverse engineering, Alexander Gitter researched the structure of file formats used by Theme Hospital and documented them in his Theme Hospital Format Specification.[1] The purpose of this site was to accumulate all information needed to eventually create an open source clone of Theme Hospital.


On 2 September 2008 a new open source project OpenTH[2] began a fresh attempt at cloning the game based on the Theme Hospital format specifications.[1] OpenTH is written in C++ and Lua and released under the GNU GPL. As of October 2011 the project is dead, as the OpenTH blog is no longer being refreshed and the OpenTH forum is down.


Launched on 24 July 2009, the project named CorsixTH[3] is another open source attempt to make a modern clone of Theme Hospital (it was born from the other open source project OpenTH, see above). It is coded in C++ and Lua, with a stronger focus on Lua than OpenTH and is licensed under the MIT License. The first official release was Playable Beta 1 on December 24, 2009 . The current stable version 0.40, was released on December 18, 2014.[4] It is necessary to have the original content of the game, because CorsixTH is only an engine recreation, but limited functionality is available by using the content files from the freely available demo. Currently the developers behind CorsixTH are working on creating their own graphics for this game to replace the ones from Theme Hospital with freely distributable ones.[5]

Android port[edit]

The Android port of Theme Hospital was released, using code directly from the CorsixTH project, by developer Allan Woolley from Armed Pineapple, who built a free version of the CorsixTH code for Android and distributed it for free on his website.[6] It requires the original game files. In December 2012, Woolley released the CorsixTH port to the Play Store.[7]

PlayStation port[edit]

There is a PlayStation port of Theme Hospital, developed by the team who also ported Bullfrog's Magic Carpet. The port is very faithful to the original, but runs at a lower resolution, lacks background music, changes the size requirement for some buildings, and has minor presentation tweaks, including a game-play based introduction video.

The PlayStation version was released as a download on the PlayStation 3 and PlayStation Portable in the EU on January 31, 2008 and in North America on August 31, 2010.

Windows port[edit]

The Windows port of Theme Hospital was actually a Win32 version of the DOS version, but all display, mouse, keyboard and sound output and input was performed using DirectX. Because of this, it still had a Low Resolution mode, despite the fact that it could only simulate it. Also, some DOS applications were still installed with it (including MIDIFORM.EXE for converting midi files, and the companion batch file).

OS X Port[edit]

The OS X port is a DOSBox port running on a similar virtual environment which allows Mac users to play the popular game without needing to install a Windows Virtual Machine.

References to other works[edit]

The opposing hospitals in the game are almost all names of well-known computers from fiction and real-life:

Also, the doctor is seen playing Dungeon Keeper in the intro video, and several Dungeon Keeper characters appear in the hospital waiting room, along with a character from an earlier Bullfrog title, Syndicate.

Influence on other games[edit]

  • The Sims 3 has a condition called "Bloatyheaditis" in the Medical career, a reference to Theme Hospital's "Bloaty Head" illness.

See also[edit]


  1. ^ a b [1], Alexander Gitter's format specification
  2. ^, OpenTH - open source Theme Hospital clone
  3. ^ CorsixTH project page, CorsixTH - open source Theme Hospital clone
  4. ^ CorsixTX releases
  5. ^ CorsixTH Graphics
  6. ^ "Running Theme Hospital on Android with CorsixTH". Armed Pineapple. Retrieved 26 May 2012. 
  7. ^ CorsixTH. Retrieved 6 February 2015.

External links[edit]