The Annual State of NHS Scotland Assets and Facilities Report for 2014, released by the Scottish Government, found that 59% of buildings are described as being in good physical condition, down from 67% in 2013.
It also found that 37% of properties need money spent in order to improve them, while 4% of the NHS estate is said to be in an unsatisfactory condition.
65% of NHS property is "functionally suitable for its current use", while 30% needs investment.
The report disclosed a maintenance backlog of £797m, a decrease of £61m on the previous year's total.
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The Scottish government said it would invest £2.75bn in NHS equipment and buildings over the next five years.
Almost half the money being invested will fund major projects in the NHS.
Health Secretary Shona Robison said: "This Government is committed to improving the quality of the NHS estate and this is why, with health boards, we have a clear plan in place to deliver the investment our health facilities need.
"This year Scotland's biggest ever hospital project, the new £842 million South Glasgow Hospital campus, will open to the public and work has also started on NHS Lothian's new Royal Hospital for Sick Children.
"These are major projects which will transform the way healthcare is delivered in Scotland, while also ensuring we provide the facilities and the capacity needed in our NHS for the future. Investment in infrastructure will also help us make best use of the NHS's finite resources – reducing the cost of maintaining older and less suitable buildings.
"I'm pleased to see from this report that the amount of backlog maintenance has reduced substantially over the last three years and the planned investment programmes will help to reduce this even further."
(IT/JP)
