Perspectives June 10, 2025

Designing vertical hospitals for compact cities

Lara Kaiser reflects on optimizing the operations of verticalized hospitals.

By 2050, around 70% of the world’s population will live in urban areas, according to the UN-Habitat’s biannual report. The report discusses strategies to accelerate global progress towards sustainable development.

Rapid urbanization, combined with intense climate change, poses challenges for sustaining urban life. These challenges are particularly apparent in a megalopolis like São Paulo, which, with more than 22 million inhabitants, is among the most populous in the world. São Paulo faces a temperature increase of at least 0.5°C by 2040.

In theory, densification is a sustainable alternative for São Paulo and similar cities around the globe. According to urban economist and Harvard professor Edward Glaeser, a compact city is beneficial for the environment, culture, and education, since it limits urban sprawl and reduces emissions, allowing for a greater mix of ideas, values and cultures.

The most recent review of São Paulo’s Strategic Master Plan (2023) outlined the goal of transforming the capital into a compact city, reducing the distances between housing, work, leisure, and essential facilities, such as hospitals. A city maintains its urban character by balancing land use and promoting typological diversity. This ensures greater population density, especially on public transportation routes, which optimizes infrastructure and enhances urban life.

In alignment with sustainable development strategies for cities, such as adapting existing buildings and creating new developments in neighborhoods with robust infrastructure, our São Paulo studio presents a new hospital in one of São Paulo’s most traditional neighborhoods. In a partially commercial region with strong residential characteristics, the hospital makes the most of limited space and is near a park listed as a municipal heritage site.

The combination of strategic planning and integration into the urban fabric allowed the team to develop an efficient vertical structure, with 65,000 square meters on a plot of land measuring just 6,300 square meters. The hospital has 302 beds organized into 15 floors above ground (plus six underground floors), with vertical circulation that optimizes the 1,800-square-meter slabs. The design organizes social, service, and outpatient access on the same façade, and the tower is integrated into the city through a central square that follows the curves of the building. Custom landscaping harmonizes the structure with its surroundings.

“Designing hospitals for cities of the future is more than just solving functional issues. It is actively participating in the construction of more efficient, healthy, and integrated cities,” says Lara Kaiser, healthcare design leader and principal at our São Paulo studio.