Contrasting associations between wages and staffing levels of nurses and physicians in Swiss acute care hospitals

This brief research report presents incremental evidence from the HONEST sub-study, which previously examined the association between nurse and physician wages and 30-day mortality in Swiss acute care hospitals. Building on this work, the present analysis examines the association between wages and staffing levels, as staffing may represent a potential mechanism linking wage structures to hospital performance. Routinely collected hospital data from the Swiss Federal Office of Statistics covering the years 2018–2020 were analyzed, with 2019 serving as the index year. Staffing levels were calculated as hours per inpatient day based on full-time equivalents and total inpatient days. Associations between wages and staffing were assessed using Spearman's rank correlation coefficients, with analyses stratified by hospital level. Nurse staffing levels were positively correlated with nurse wages across all years, although the associations were modest overall ( ρ = 0.22–0.38, p < 0.001). In contrast, physician staffing levels showed a moderate to strong inverse correlation with wages ( ρ = −0.56 to −0.61, p < 0.001). While the physician results are consistent with typical hospital workforce structures, the positive association between nurse staffing and wages was less expected. These findings highlight the limited empirical evidence on wage–staffing relationships in hospitals and highlight the complexity of workforce dynamics. Given the descriptive and cross-sectional design, the results should not be interpreted as causal, and the underlying mechanisms remain unclear. Further research is needed to better understand how wage structures and workforce composition are associated with staffing patterns in healthcare systems.