Should you avoid hospitals?

[An Ning]

Simple question.
Whenever I start putting in hospitals, I literally cannot stop.
They quickly exceed max capacity, leading to strikes and constant "there is a strike" notifications until I put in so many hospitals that my city is no longer making money.

I have cities that spend almost 4000 a month just in hospitals in order to keep them under capacity... and unlike schools, which make for higher-paying jobs and more city profit down the line... clinics just seem to be a black hole on a bank account.

So.. are clinics and hospitals things to avoid?

[WhatWillTheNextDowndateBring?]

You know, there maybe truth in this, someone made a video on SC3K where he presented his relentless work trying to make the biggest city possible in that game, he didn't build hospitals.

One thing I noticed is that if Hospitals and Clinics have overlapping radii, the patients within seem to get duplicated instead of being split between the two. So if you are going to build up your city's healthcare infrastructure, only build hospitals, they're cheaper to run in staff and ambulance costs.

[nobrainer]

No, they are not things to avoid.
You simply have to adjust the "ambulance budget" slider in order to reduce the radius of a particular hospital to reach a point where the capacity of the hospital can actually take care of the population that is within its radius.

[WhatWillTheNextDowndateBring?]

That doesn't always work as there have been many times I've had overcrowded schools, hospitals ect even with no bus/ambulance funding and that obviously means sims are getting left out.

[NetPCDoc]

I have found that distrubuted Health Care can assist in cutting costs ...

That is place ONE hospital so as to allow four or more Clinics to feed in to it. If a clinic is within the ambulance range of a Hospital - then the clinic overflow will go to the Hospital; this also allows the clinic to act as a triage buffer for the Hosiptal. When a hospital overflows you need a larger medical center within ambulance range to accept that hospital's overflow.

The main trick is to use clinics to cover residential zones; and keep the hospitals as far from the residential zones as possible, while still being withn the ambulance range of multiple clinics.

[WhatWillTheNextDowndateBring?]

Yeah, well, it'd be nice if clinics did that, but they don't, not in my Deluxe experiance anyway: https://steamcommunity.com/sharedfiles/filedetails/?id=922052167 https://steamcommunity.com/sharedfiles/filedetails/?id=922053086 Two clinics (above) and a hospital (below) serving a minor town. https://steamcommunity.com/sharedfiles/filedetails/?id=922053763 A total of ~4,600 patients, hence I've set the hospital funding to 800, good for 2,400 patients in preparation of getting rid of the clinics and building a second hospital with the same level funding.

https://steamcommunity.com/sharedfiles/filedetails/?id=922054632 Wait, what?!?!?! Where did a third of the patients go?!?!?! <All the clinic patients were duplicates.>

[NetPCDoc]

Originally posted by richnathaniel9419:

Yeah, well, it'd be nice if clinics did that, but they don't, not in my Deluxe experiance anyway:

Critque of pictured situation:

In the Date View, DO pay attention to the "shaded" tiles (red | green | etc), as this is where your health care demand is at!

You appear to have two "small" clinics (Hospitals VII & VIII) - where you should only need one; BUT you should keep ONE and consider adjusting the ambulance funding to cover the "red shaded" tiles (in that general neighborhood).

In this particular case it looks like you could hire a few more doctors and probably cover the current needs with just one Medical Center, while reducing the ambulance funding to where the clinic is just inside the Medical Center's ambulance range.

And when that Medical Center's capacity (with maximum number of doctors) is exceeded, consider building a larger medical facility - in addition to (not in place of) the two mentioned facilities.

Topic recap:

My point is that, when setting up health care, one needs to focus first on the ambulance range; and only after you have the proper ambulance overlaps do you worry about patient capacity.

Where one might have FOUR (count them: 4) overwhelmed clinics with employee strike concerns, one centrally located hostipal can easily provide overcrowding relief to all four clinics - when the ambulance ranges are properly configured. And such clinics can provide triage services to such a central hospital to help prevent it from becoming overcrowded; of course, while such hospitals may provide a certain amount of mutal assistance to each other, should the city population get high enough one will eventually need city wide health service facilities.

Proper ambulance service may, for some, be somewhat tricky. Depending on the number of patients, overlapping ambulance ranges may suffice, or it may require placing one of the (health service facility's) buildings within the ambulance range of the other facility. In any case the patient capacity (number of Doctors) funding needs to be adjusted based on the actual usuage.

Educational levels, fire & police services, and some city ordinces might also have an impact on health care needs.

[WhatWillTheNextDowndateBring?]

Thanks for confirming to me you have no idea what you're talking about!

Originally posted by NetPCDoc:

You appear to have two "small" clinics (Hospitals VII & VIII) - where you should only need one; BUT you should keep ONE and consider adjusting the ambulance funding to cover the "red shaded" tiles (in that general neighborhood).

In this particular case it looks like you could hire a few more doctors and probably cover the current needs with just one Medical Center, while reducing the ambulance funding to where the clinic is just inside the Medical Center's ambulance range.

Both "small" clinics already have no ambulance funding and yet have over 700 patients, well over the 500 they're meant to handle and even the 550 when overfunded. How you can try to claim that town should only need one clinic when it already has two with no ambulance funding that are WAY over crowded is just... so amazingly beyond any ounce of reason.

Originally posted by NetPCDoc:

And when that Medical Center's capacity (with maximum number of doctors) is exceeded, consider building a larger medical facility - in addition to (not in place of) the two mentioned facilities.

Bro, please tell me you're tripping right now... that town already had "a larger medical facility in addition to (not in place of) the two mentioned facilities", and guess what!!! It too with over 3,000 patients is over it's normal capacity, though this time only just.

Now assuming clinics and hospitals did share patients between them, you would be right in saying another centrally placed clinic would take care of the current overcrowding pictured as a third of the patients of the two clinics would go to the new one. Wait, no, probably only a quarter would as there's also the large hospital and a quarter being moved elsewhere wouldn't be enough.

However, again, that's assuming clinics and hospitals do share patients, they don't, that was my point and you clearly missed that when you when on to type the rest of your nonsense.

Originally posted by NetPCDoc:

Educational levels, fire & police services, and some city ordinces might also have an impact on health care needs.

As much as it would be nice if that last bit you said were true, it sadly isn't, not in unmodded Simcity 4 anyway, the total number of paients is simply 2 out of every 25 sims. Meaning, you need a large hospital for every 37,500 sims, hence why that town of 38,000 had the just over 3,000 patients pictured and why that number halved when I built the second hospital which also covered the entre residential area, also hence why in this screenshot: https://steamcommunity.com/sharedfiles/filedetails/?id=875957563 This other town of just under 25,000 sims has just under 2,000 patients, 2 out of 25 ratio.

[MGB]

Hospital capacities, like with many services just don't scale well. So yes, if you want proper working healthcare without modding, you'll be placing them every few blocks in a city full of skyscrapers. This issue isn't unique to SC4, but plagues pretty much every city simulator ever made. OK SimCity (2013) isn't a shinning example of a game, but it did have some good ideas. On such idea was upgradable public services/utilities, where you upgrade facilities to meet growing demands. However your options are limited to the small (basically ineffective with a large city), medical clinic or the main hospital. Not every sim will need to use a hospital, but when you have high-level (stage 8) skyscrapers, you may have 3,000 sims in one building. So a block with just 9 such buildings can easily test the limits of a single hospital within coverage range.

My personal solution, simply get some modded hospitals with much greater capacities than the original game. Not having suitable healthcare will affect your game if you want rich sims and the benefits they bring to a region.

[NetPCDoc]

Available Health Care facilties (including unlockable rewards) in my cities:

• Medical Clinic
• Large Medical Center
• Disease Research Center
• Memorial Hospital
• Advanced Research Center
• Farmer's Market

FYI: documenation, from way back when, states that coverage is less at outer edges of coverage radius than at center thereof; so you may want to overlap outer edges ... but placing like facilities next to each other hits dimenishing returns a lot sooner! ... and unlocking larger facilities tends to be a case of meeting a certain percentage of capacity at a certain number of smaller facilities.

As stated, you should only need ONE "Small Clinic" where shown in the linked "Hospitals Vi" & "Hospitals VII" pictures, with more ambulance funding - to increase coverage to include the shown red shaded tiles. Alternatively, you could place four (4) Small Clinics (one at each corner of the coverage area), each to cover one quarter of the required coverage area; with a single Large Medical Center located where the Small Clinics are shown to be. .. and the "Hospitals VIII" shows that you could hire more doctors to increase the patient capacity, at least enough to cover the shown number of patients.

The "Disease Research Center" & the "Advanced Research Center" - when unlocked - are able to provide some relief on number of patients at your "Large Medical Center(s)".

And the game will NOT instantly transfer numbers of patients upon placement of a facility ... may take up to a game month for numbers to settle down to stable values.

[MGB]

Both the Disease Research Center and Farmer's Market are not technically hospitals. They do improve the health of sims within coverage, but they work very differently. As such, they are not a replacement for hospitals, but can help as part of a wider healthcare network.

I've no idea what the Memorial Hospital is, to my knowledge that's not something included in the base game of SC4 Deluxe.

The advanced research centre has nothing to do with healthcare. This improves demand for I-HT buildings in your city.

[WhatWillTheNextDowndateBring?]

Originally posted by NetPCDoc:

Available Health Care facilties (including unlockable rewards) in my cities:

• Medical Clinic
• Large Medical Center
• Disease Research Center
• Memorial Hospital
• Advanced Research Center
• Farmer's Market

FYI: documenation, from way back when, states that coverage is less at outer edges of coverage radius than at center thereof; so you may want to overlap outer edges ... but placing like facilities next to each other hits dimenishing returns a lot sooner! ... and unlocking larger facilities tends to be a case of meeting a certain percentage of capacity at a certain number of smaller facilities.

As stated, you should only need ONE "Small Clinic" where shown in the linked "Hospitals Vi" & "Hospitals VII" pictures, with more ambulance funding - to increase coverage to include the shown red shaded tiles. Alternatively, you could place four (4) Small Clinics (one at each corner of the coverage area), each to cover one quarter of the required coverage area; with a single Large Medical Center located where the Small Clinics are shown to be. .. and the "Hospitals VIII" shows that you could hire more doctors to increase the patient capacity, at least enough to cover the shown number of patients.

The "Disease Research Center" & the "Advanced Research Center" - when unlocked - are able to provide some relief on number of patients at your "Large Medical Center(s)".

And the game will NOT instantly transfer numbers of patients upon placement of a facility ... may take up to a game month for numbers to settle down to stable values.

Bro, stop embarrising yourself! Okay so first, like MGB, I too have never heard of the Memorial hospital and therefore also think it's not in base SC4 or Deluxe. So, maybe everything you say might work the way you say it does in whatever mod you use? But unmodded is a different story.

You claim the coverage is less on the outer edges, uhuh, and? You think I'm not aware of that? Those screenshots are not meant to be representing an ideal heathcare system, they're showing how clinics and hospitals don't share patients in refutation of claims by you stating otherwise.
The history of that town is (after I assumed controll from where it was left off at since it's premade), I continued with just the clinics already built, lowering the ambulance funding once overcrowded, then built the large hospital when they got overcrowded again despite no ambulence funding.
Finally, at the point which I made the screenshots at, I was going to build a second hospital since the first was at capacity and also remove the clinics, all that was already stated in the post... again, as stated in the post, adding the total number of patients from both clinics and the hospital totaled just under 4,600, so I adjusted the funding of the existing hospital to 800, good for 2,400 patients. (Or half of the total number of patients, plus a bit of room spare for future population growth.)
So, given that history, of course the centre is going to have better healthcare!!! Since the centre for a long time got all the heathcare and, more recently, doubled heathcare, probably, since the patients in the centre were being duplicated between the clinics and hospital! Enough history.

So, you again claim only one clinic should be at the centre, seriously now? You're really going to double down on that complete nonsense? Not only that, but increase it's ambulance funding lol?! BOTH CLINICS ARE ALREADY OVERCROWDED AND HENCE STRIKING YOU MORON!!! Suggesting I double the load of one of the clinics by destorying the other and then further increase it's load by increasing the ambulance funding makes zero sense whatever! The only smart thing you said there was building a hospital where the clinics are! But building 4 clinics on the edge? That's super dumb... sure, it would focus short term healthcare where it's needed most due to the history of the town mentioned before, but long term, it'd make no difference where I build things provided I have complete coverage and enough capacity. Therefore, going economically at least, suggesting I build 4 clinics, costing 1,200 per month (minus ambulances), good for 2,000 patient, makes no sense when a hospital is good for 3,000 for 1,000 per month (minus ambulances)! Also, yet again... clinics and hospitals don't share patients!!! How do you keep skipping over that?
Since they don't share patients, it's one or the other or else duplication and hospitals are far more economically viable. Clinics only work in smaller scale enviroments SORT OFF, though really you only should build them for the look, as in maybe you think a hospital just looks too out of place in a low density area which I don't disagree with.

Lastly, telling me how things doesn't update instantly wasn't necessary you condescending turd... the after screenshot shows 1,517 patients in one of the hospitals, none of the before screenshots show that number of patients, meaning that was already accounted for. 14 days had also passed between the befores and after screenshots, lending even more proof. I suggest you be very careful if you attempt to make another reply and definately drop the unearned condescending tone, unless, of course, you're fine just getting totally rekt again!

[NetPCDoc]

My appologies for appearing to be "condescending". That was not my intention. But I have successfully shared patients between clinics and medical centers!

At the moment I am in the middle of an oversized SC4Terraformer project that has my regions totally disorganized, and therefore can not (at this time) give you a screen shot showing just what I am saying.

[WhatWillTheNextDowndateBring?]

Well, I will admit that others have also claimed clinics and hospitals share patients and may have also provided proof of it too, it might be just a glitch only present in premade regions or towns, IDK. Reguardless, even if they did share patients, clinics are way too expensive and can only MAYBE win on space efficiency grounds. They're as space efficient as eachother, but, if you're not taking advantage of the extra capacity of the hospital, the clinic technically becomes more space efficient. How bad are clinics economically? For the 300 a month it costs a clinic to look after 500 patients, you could look after 900 with a hospital, or instead, for 170 a month, look after 510 with a hospital. That's nearly double the value, and it's the same story, if not maybe even better for ambulances!

[Medic Main]

Originally posted by richnathaniel9419:

Originally posted by NetPCDoc:

Available Health Care facilties (including unlockable rewards) in my cities:

• Medical Clinic
• Large Medical Center
• Disease Research Center
• Memorial Hospital
• Advanced Research Center
• Farmer's Market

FYI: documenation, from way back when, states that coverage is less at outer edges of coverage radius than at center thereof; so you may want to overlap outer edges ... but placing like facilities next to each other hits dimenishing returns a lot sooner! ... and unlocking larger facilities tends to be a case of meeting a certain percentage of capacity at a certain number of smaller facilities.

As stated, you should only need ONE "Small Clinic" where shown in the linked "Hospitals Vi" & "Hospitals VII" pictures, with more ambulance funding - to increase coverage to include the shown red shaded tiles. Alternatively, you could place four (4) Small Clinics (one at each corner of the coverage area), each to cover one quarter of the required coverage area; with a single Large Medical Center located where the Small Clinics are shown to be. .. and the "Hospitals VIII" shows that you could hire more doctors to increase the patient capacity, at least enough to cover the shown number of patients.

The "Disease Research Center" & the "Advanced Research Center" - when unlocked - are able to provide some relief on number of patients at your "Large Medical Center(s)".

And the game will NOT instantly transfer numbers of patients upon placement of a facility ... may take up to a game month for numbers to settle down to stable values.

Bro, stop embarrising yourself! Okay so first, like MGB, I too have never heard of the Memorial hospital and therefore also think it's not in base SC4 or Deluxe. So, maybe everything you say might work the way you say it does in whatever mod you use? But unmodded is a different story.

You claim the coverage is less on the outer edges, uhuh, and? You think I'm not aware of that? Those screenshots are not meant to be representing an ideal heathcare system, they're showing how clinics and hospitals don't share patients in refutation of claims by you stating otherwise.
The history of that town is (after I assumed controll from where it was left off at since it's premade), I continued with just the clinics already built, lowering the ambulance funding once overcrowded, then built the large hospital when they got overcrowded again despite no ambulence funding.
Finally, at the point which I made the screenshots at, I was going to build a second hospital since the first was at capacity and also remove the clinics, all that was already stated in the post... again, as stated in the post, adding the total number of patients from both clinics and the hospital totaled just under 4,600, so I adjusted the funding of the existing hospital to 800, good for 2,400 patients. (Or half of the total number of patients, plus a bit of room spare for future population growth.)
So, given that history, of course the centre is going to have better healthcare!!! Since the centre for a long time got all the heathcare and, more recently, doubled heathcare, probably, since the patients in the centre were being duplicated between the clinics and hospital! Enough history.

So, you again claim only one clinic should be at the centre, seriously now? You're really going to double down on that complete nonsense? Not only that, but increase it's ambulance funding lol?! BOTH CLINICS ARE ALREADY OVERCROWDED AND HENCE STRIKING YOU MORON!!! Suggesting I double the load of one of the clinics by destorying the other and then further increase it's load by increasing the ambulance funding makes zero sense whatever! The only smart thing you said there was building a hospital where the clinics are! But building 4 clinics on the edge? That's super dumb... sure, it would focus short term healthcare where it's needed most due to the history of the town mentioned before, but long term, it'd make no difference where I build things provided I have complete coverage and enough capacity. Therefore, going economically at least, suggesting I build 4 clinics, costing 1,200 per month (minus ambulances), good for 2,000 patient, makes no sense when a hospital is good for 3,000 for 1,000 per month (minus ambulances)! Also, yet again... clinics and hospitals don't share patients!!! How do you keep skipping over that?
Since they don't share patients, it's one or the other or else duplication and hospitals are far more economically viable. Clinics only work in smaller scale enviroments SORT OFF, though really you only should build them for the look, as in maybe you think a hospital just looks too out of place in a low density area which I don't disagree with.

Lastly, telling me how things doesn't update instantly wasn't necessary you condescending turd... the after screenshot shows 1,517 patients in one of the hospitals, none of the before screenshots show that number of patients, meaning that was already accounted for. 14 days had also passed between the befores and after screenshots, lending even more proof. I suggest you be very careful if you attempt to make another reply and definately drop the unearned condescending tone, unless, of course, you're fine just getting totally rekt again!

Why do you have to be so toxic?

[WhatWillTheNextDowndateBring?]

Why do you want to marry me?