Abstract: Objective: To investigate the matching status between nursing workforce supply and patients' care demands in primary medical institutions across Chongqing, and to analyze urban-rural disparities and relevant influencing factors, to provide a reference for optimizing the allocation of regional grass-roots nursing human resources. Methods: In May 2026, stratified cluster sampling was conducted. Primary medical institutions in Chongqing were stratified by institution type, and randomly selected using the institution as the cluster unit. Patients visiting during the survey period were consecutively recruited. Data were collected using a general information questionnaire and the Community Nursing Demand Scale for Patients with Chronic Diseases. The entropy weight method was adopted to assign weights and develop a nursing workforce supply index. A coupling coordination model and supply-demand matching index were applied to assess the balance between workforce supply and patient needs. Hierarchical multiple linear regression was performed to identify factors associated with the degree of supply-demand mismatch. Results: Valid data from 708 primary medical institutions and 984 patients were included. Nursing supply was significantly higher in urban primary facilities than in rural counterparts (P<0.001). Rural patients reported greater needs for disease management and health promotion (P<0.05). The supply-demand matching index stood at 0.253 for urban areas and 0.166 for rural areas, both indicating supply lag; coupling coordination degrees were 0.533 and 0.490, respectively, with rural regions on the verge of coordination imbalance. Hierarchical regression analysis revealed that the presence of an independent nursing management department, having dedicated staff to manage nursing quality, the number of licensed nurses, and the number of nurses with intermediate professional titles were critical protective factors for narrowing the supply-demand deviation (all P<0.001). Conclusion: There exists a prominent urban-rural divide and an overall shortage of nursing workforce in primary medical institutions of Chongqing, with far more severe supply-demand conflicts in rural areas. Nursing management efficiency and workforce talent structure constitute core determinants of supply-demand matching. Targeted preferential policies differentiated by urban and rural contexts are recommended. Authorities should strengthen the construction of standardized nursing management systems and optimize the structure of nursing talent echelon.

Key words: primary medical institution; nursing human resources; supply-demand matching; urban-rural disparity; chronic disease; nursing administration