Abstract: Objective: To systematically assess the stratified allocation status of nursing human resources in Tianjin and to project demand trends for the 15th Five-Year Plan period, thereby providing support for the rational development of regional nursing workforce planning. Methods: Based on the data such as the number of registered nurses and actual open beds in Tianjin from 2015 to 2025, the Grey Model, and supply-demand gap analysis were used to conduct stratified evaluations and quantify workforce shortages across tertiary hospitals, secondary hospitals, and primary healthcare facilities. Results: By the end of 2025, Tianjin had 54,700 registered nurses, with 3.99 registered nurses per 1,000 population and a physician-to-nurse ratio of 1?:?0.90. The nurse-to-bed ratio was 1?:?0.70 in tertiary hospitals (1?:?0.54 in tertiary Traditional Chinese Medicine institutions) and 1?:?0.57 in secondary hospitals. The physician-to-nurse ratio in primary healthcare facilities was 1?:?0.56. Based on national and Tianjin nursing development planning standards, the total stratified supply-demand gap in 2025 amounted to approximately 17,028 nurses, with primary institutions accounting for the largest share (43.11%). The Grey Model predicted that registered nurses would reach 71,211 in Tianjin by 2030, and the projected supply per 1,000 population would be 5.36 (C=0.103 and 0.120, all P=1.000, excellent accuracy). Conclusion: Tianjin faces both an overall shortage and structural imbalances in its nursing workforce, with particularly critical deficits in tertiary Traditional Chinese Medicine institutions and primary healthcare facilities. We recommend implementing tiered precision allocation strategies, with priority given to strengthening the primary care nursing workforce, and ensuring dynamic matching between nursing manpower and residents' health needs.

Key words: nursing human resources; Grey Model; tiered allocation