chapter  Chapter 10
32 Pages

The growth and change of hospital buildings

WithKazuhiko Okamoto

Statistics demonstrate that the average durable life of architecture in Japan is much shorter than other developed countries. In regard to reinforced concrete hospitals, the average life span before rebuilding is 31 years, which is almost the same as wooden houses in Japan. Some of the biggest reasons for this short useful life of hospitals are demographic changes, development of medical equipment, and replacement of architectural equipment, all of which require unexpected spaces. In order to accommodate these changes, the concept of growth and change in hospital architecture, proposed by British architect John Weeks (1921–2005), was introduced to Japan in the 1960s. However, recent research reveals that a similar concept had been imported in 1923 from United States and its application had been attempted even before Weeks’s concept. Because these applications might have not gone well, we now confront the “31 years” phenomenon, and are still groping for a way to make long-lasting hospital architecture. In this chapter, we classify the methods used to prepare for future growth and change implemented in the last 50 years at 183 hospitals in Japan and 56 hospitals overseas, and overview the key to realizing long-life hospital facilities. In addition, we examine a well-known case study: The University of Tokyo Teaching Hospital (established in 1876), on the basis of interviews with key persons in design. While we do not have information on all the internal growth and change of this 140-year-old hospital, these interviews reveal the reason of large external growth and change. This chapter is based on the author’s research “Study Report on the Growth and Change of Hospital Architecture.”