Changes in higher vocational nursing programme sites in China and their alignment with regional health service demand: implications for nursing workforce planning

Abstract

Abstract Background To explore the changes in higher vocational nursing programme sites in China in 2013–2025 and analyze their distribution between regional health service demand, to provide evidence on optimizing the layout of nursing vocational education and to provide information for nursing workforce planning. Methods Data of the higher vocational nursing programme sites in each province-level region in China between 2013 and 2025 were retrieved from publicly available information from the National Platform for Vocational College Specialty Setting Management and Public Information Services and other official sources. These data were merged with official 2024 data on the population of the country, population of 65 years old and above, and the regional gross domestic product to describe the changes at the national, regional, and provincial levels of the country of the programme sites. To create a regional health service demand index and relative higher vocational nursing education supply index, indicators of regional health service demand and relative higher vocational nursing education supply were standardized. The relative supply index was operationalised as the population-adjusted number of programme sites. Demand–supply alignment was then evaluated by quadrant analysis across provinces, and sensitivity analysis was performed to investigate the stability of results. Results The number of higher vocational nursing programme sites in China from 2013 to 2025 grew by 74.47%, from 333 to 581. Programme sites grew in each region, with the level of growth and provincial distribution showing a significant variation. East China recorded the highest number of programme sites, and the province-level regions of Guangdong and Sichuan recorded the highest numbers of 41 sites each in 2025. The 31 province-level areas were split into four quadrants: high demand-low relative supply; high demand-high relative supply; low demand-high relative supply; and low demand-low relative supply. The results of the sensitivity analysis revealed that three of the 31 province-level regions changed quadrant classifications, suggesting the main findings to be relatively stable. Conclusions Overall, the number of higher vocational nursing programme sites in China grew significantly from 2013 to 2025, although there were disparities between regions and provinces. Some provinces with large populations, high health service demand, and greater ageing-related pressure had relatively large numbers of programme sites, yet still showed insufficient relative supply when compared with regional health service demand. These results indicate that judging the adequacy of higher vocational nursing education supply solely by the number of programme sites—which reflects the availability and distribution of educational provision rather than educational capacity, graduate output, or nursing workforce supply—may be insufficient. It is not necessary to concentrate solely on the expansion of programme sites to optimize higher vocational nursing education in the future. Rather, the regional population structure, primary care and elderly care needs, clinical teaching resources, enrolment capacity and clinical graduates’ employment destinations should be considered. Trial registration Not applicable.