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© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.BACKGROUND There are known clinical benefits associated with investments in nursing. Less is known about their value. AIMS To compare surgical patient outcomes and costs in hospitals with better versus worse nursing resources and to determine if value differs across these hospitals for patients with different mortality risks. METHODS Retrospective matched-cohort design of patient outcomes at hospitals with better versus worse nurs