Dice Hospital Review

Doctor Doctor, I’m covered in spots!
Oh do pip down.

Doctor Doctor, what are my chances?
About 1 in 6.

Dice Hospital

Players: 1-4
Times: 45-90 mins
Designer: Stan KordonskiyMike Nudd
Artist: Sebastián KozinerSabrina Miramon
PublisherAlley Cat Games,


Dice Hospital is a satire wrapped in family friendly paper. Like the best children’s cartoons it offers this charming setting with an easy to grasp hook: you are running a hospital, for dice! But start scratching at that surface and all you are left with is uncomfortable questions and that dirty feeling associated with a really good black comedy.

Dice Hospital start

What is going on here? Well, dice are patients, and their pips are their health. It’s a beautifully elegant piece of design. The available actions naturally provide the ability to increase the value of your dice, steadily raising them to 6 and then once more to discharge them from your hospital. Hurrah! You’re a hero!

But where there is the chance for survival, there is also the opportunity for decline. Treatment requires doctors and rooms. Each room provides a particular type of action, perhaps healing a yellow die, or a specific starting value, one pip. Later rooms might let you heal a pair of 1 or 2 value dice 2 pips or some specific combination of red dice. But as each room can only be used once and only so many doctors are available, each round inevitably ends with some dice untreated (tracked via the less elegant solution of sliding dice to the bottom half of a ward when you heal them at all). These neglected dice drop one pip, bringing them closer to that tragic zero, and a trip to the morgue. How could you let that happen? You monster.

Dead dice

Dice Hospital does not shy away from death. Oh no. It revels in it. As the great Ian Banks once said, a utopia is boring, and so it is here. The excitement of Dice Hospital, what makes it a game, is being held close to the edge of collapse and fighting, if not for your own survival, then the survival of your precious dice.

Your starting hospital, with its basic rooms and handful of nurses is woefully underequipped to deal with the tide of dice coming your way. Each round begins with players drafting ambulances filled to bursting with new patients spread between 2 and 5 in value. What happened to the 1s? They were left behind. You save who you can.

You have space for 12 dice in your wards, that gives you breathing space. But it’ll soon disappear and each new dice is another drain on your already stretched resources. By round 4 (of 8!) You had better of discharged some patients or you won’t have any space for the newcomers. And then people start dying.

Dice Wards

The hospital is full, do the drivers move on? No, this is no charming co-op. You must choose dice to go to the morgue, to make enough space. You’ll choose the lowest value ones. They were never going to make it out anyway. It’s a kindness really. You did it for the greater good. But you’ll still lose 2 points per death.

Those ambulances decide who gets first pick of new rooms and doctors. There’s an advantage to taking the sickest dice! All of the rooms are better than where you start. All of the doctors add a little bonus to the action, but almost more importantly let you use more actions overall. But the challenge isn’t as straightforward as you might think. Each room can only be used once, and you need dice of the right values to benefit from many of the powers. It’s easy to find you’ve healed dice too much and now can’t use the emergency low value rooms. Wait… you mean I should tactically neglect patients so I can be more efficient next turn? You’re right. It’s efficiency that matters most.

Dice Hospital Workers Placed

Taking that further still is the scoring system. Each round you’ll earn points for the dice you’ve discharged from the hospital. But the points scale higher for releasing more dice at once. Resulting in the perverse encouragement to keep healthy dice in the hospital for longer to build up to bigger turns… keeping them under observation as it were. But this fills beds and so brilliantly achieves that aim of keeping you on the edge. Either discharging dice earlier than you want to because the wards are filled or holding people back in the hope you can unleash them all in a massive turn.

It’s never obvious what the right path is. The decision space is too large to evaluate fully and so you go with what feels right, even though you inevitably run afoul of your own mismanagement. But it’s a failure of degrees not a complete collapse. And that keeps Dice Hospital engaging through to the end.

Dice Bag

It is not perfect. It suffers from some inevitable issues with keeping track of actions. You’ll forget which dice you’ve healed by halfway through a round of activating your hospital, making it very hard to wind back your turn if you make a mistake, and very easy to forget which dice you have treated if you are not diligent in changing their position in a ward. Furthermore, aside from that early draft, it’s very much a head down figure out your own puzzle and trust no one else has accidentally cheated kind of game. Which will be the defining characteristic for many people.

But what a well crafted puzzle it is. Choosing which doctor to place where is weighty. The potential combos from drafting the right combinations of rooms and doctors and dice are satisfying and give you a different hospital to deal with each time you play, each round you play as you go from provincial gp’s office to specialised national centre for dice medicine.

It means a game of Dice Hospital results in something much more taxing than you expect from its charming cover. By rounds 7 and 8 expect a silent table bar the mutterings and gentle repositioning of dice. But while that is not because of rules, it’s also not due to strategic depth. More an exponential increase in options and a game that leans into its efficiency optimisation puzzle. It’s a game with thematically broad appeal but mechanically is that much more constrained.

Dice in Room

I’ve slightly exaggerated the thematic underpinnings but the mechanics speak for themselves. Dice Hospital can absolutely be read as some satire on modern, targets driven medicine. It never gets explicit but it is also not beneath revelling in its own absurdity, the artwork on each tile being the most obvious example. And I kind of love it for that! It is enough theme to elevate its mathematically rigorous mechanics and which has just enough edge to really amuse me during play. So it earns a positive appraisal from me, but be sure to get a second opinion.

Rating: a clean bill of health

Our copy of Dice Hospital was provided for review by Asmodee UK. You can get hold of a copy for £41.99 From your local hobby store.

For a detailed how to play, check out Gaming Rules!

And screw it, while I’m posting videos I may as well shout out our own unboxing video!

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