Massachusetts’ Question 1, a ballot initiative that would have established mandatory nurse-patient ratios in hospitals was defeated during the general election Tuesday.

The Massachusetts Nurses Association, a union representing nurses in 51 acute care hospitals across the state, conceded defeat around 9 p.m. Tuesday evening.

At approximately 10:20 p.m., the initiative had 969,400 votes against and 416,720 votes in favor, with more than 50 of precincts reporting, according to the preliminary results.

“We are all disappointed by tonight’s results and the impact this will have on the patients we care for every day,” MNA President Donna Kelly-Williams said in prepared remarks. “We know that right now – as I speak to you here – there are nurses caring for too many patients and those patients are unnecessarily being put in harm’s way. And the problem continues to grow every year. The status quo is not a solution here.”

The outcome was a victory for the Massachusetts Health and Hospital Association, who opposed the initiative for fear that it would dramatically increase state healthcare costs. The association represents 70 hospitals across the state.

“This is the beginning of a conversation, not the end,” MHA President and CEO Steve Walsh said in a statement to Mass Live. “Question 1 forced some difficult and necessary discussions about the future of healthcare and the future of our workforce going forward. These conversations with our care teams and in our communities have been critically important and will continue in bargaining sessions, legislative debates, board rooms and newspapers.”

An independent study conducted by the state’s Health Policy Commission found that implementing the mandate would cost an estimated $676-949 million per year and potentially save $34-47 million. The study also found that hospitals would need to hire 2,286 to 3,101 additional full-time equivalent nurses to meet the mandate.