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An Avison Young Topical Report

The path of health care’s evolution through time could be traced through the physical space that it occupied for the delivery of medical care, which reveals the type and quality of care provided at the time, and reflects the prevailing socio-economic drivers and social attitudes with regards to illness and the sick.

Health care and the debate over its reform, not only in the United States, but all around the world, evolved in response to critical socio-economic shifts. From the Industrial Revolution in the United States to post World War II prosperity and the rise of American consumerism to the Cold War, globalization and the more recent Great Recession, the health care sector has been constantly confronted with new challenges and opportunities and the growing inefficacies in the delivery of care owing to radical shifts in demographics and health care needs.

Today, high per-capita health care costs that dwarf those of other developed nations,1 a failing Health Maintenance Organization (HMO) care system,2 the increasing struggle of hospitals — particularly rural hospitals — to stay afloat,3 the widening gap in health care coverage across the nation,4 the growing demand for health care from an aging population, as well as a looming physician shortage projected as early as 2020,5 are all factors that are driving necessary changes in the health care sector. 

In the dawn of a potential repeal of the Affordable Care Act (ACA),6 the first-ever United States government legislation aimed at closing the gaps in health care coverage nationwide and creating more efficient and affordable health care, the health care sector continues headlong on its path of evolutionary transformation. Propelled by continuous advancements in technology, patient lifestyle changes, and pressures for cost containment and reduction, the health care sector has been, from the very early days of the medical practice, in a state of flux. 

From home-based independent doctors’ offices and the first established hospital to today’s burgeoning landscape of off-hospital campus outpatient medical facilities, the health care real estate landscape has undergone significant transformations. Now straddling several property sectors, from office to retail, industrial, residential and other types of specialized use space such as kiosks in airports and mobile clinics, medical space has been cropping up in places that would have been unfathomable in the past.

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