Citizens' access to India's health facilities rise as median costs remain low, insurance coverage improves
New Delhi, April 29
The National Statistical Office's 80th Round household health survey found substantial gains in access to public healthcare and a sharp expansion in government‑financed insurance coverage, the government said on Wednesday.
The Ministry of Health and Family Welfare said the survey found that median out‑of‑pocket costs for many patients per hospitalisation stood at Rs 11,285, while over half of hospitalisations in public facilities incur only Rs 1,100.
Only a small number of high-cost cases have been observed to push up the average (mean value). This showed that high expenditure is not widespread but limited to specific cases requiring specialised treatment, an official statement said.
The survey analysed responses of 1,39,732 households including 76,296 in rural areas and 63,436 in urban areas.
Importantly, for non-hospitalisation (outpatient) care, the median OOPE in public health facilities is Zero, reflecting that a large proportion of citizens are able to access essential healthcare services entirely free of cost.
The government's Free Drugs Service Initiative (FDSI) and Free Diagnostics Initiative (FDI) launched in 2015 has ensured availability of free medicines and diagnostic services to people even in the remotest areas of the country.
Health‑seeking behaviour has strengthened as the proportion of population reporting ailments (PPRA) nearly doubled to 12.2 per cent in rural areas from 6.8 per cent in 2017‑18 and to 14.9 per cent in urban areas from 9.1 per cent.
The survey noted utilisation of public outpatient services in rural areas increased from 28 per cent in 2014 to 35 per cent in 2025.
Over 1.84 lakh Ayushman Arogya Mandirs (AAMs) across the country significantly expanded the scope of comprehensive primary healthcare by delivering preventive, promotive, and curative services closer to communities. These centres are also leveraging digital health innovations to improve access.
Financial risk protection has expanded significantly with the rapid scaling up of Government-financed health insurance coverage, under Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (PM-JAY) and various state schemes. Percentage of population covered under these schemes has nearly tripled from 12.9 per cent to 45.5 per cent in rural areas and from 8.9 per cent to 31.8 per cent in urban areas.
The statement also noted a declining trajectory of out-of-pocket expenditure among the bottom two consumption quintiles, demonstrating that economically weaker sections are deriving the greatest benefit from government interventions.
The survey also highlights continued progress in maternal and child health outcomes, with institutional deliveries increasing from 90.5 per cent in 2017-18 to 95.6 per cent in 2025 in rural areas and from 96.1 per cent to 97.8 per cent in urban areas.
— IANS
Reader Comments
As someone who works in healthcare analytics, these numbers are impressive. The median OOPE of ₹11,285 per hospitalization is extremely low by global standards. But I'm curious about the "small number of high-cost cases" mentioned—are these for rare diseases or cancer treatments? Would love to see more disaggregated data on that.
Good progress, but let's not get carried away. I've seen Ayushman Arogya Mandirs in my village—they're functional but often lack diagnostic equipment and medicines. The scheme is excellent on paper, but ground reality varies. My aunt had to travel 40 km for a simple blood test because the local AAM didn't have basic lab facilities. We need implementation, not just coverage.
The doubling of PPRA (people reporting ailments) is fascinating—it shows people are actually going to doctors now instead of ignoring symptoms. That's a cultural shift. Also, 95.6% institutional deliveries in rural areas is a massive achievement. My grandmother delivered at home in the 1960s, and my mother in a small clinic in the 1990s. Seeing these numbers makes me proud of how far we've come. 🇮🇳
I'm a doctor working in a CHC in rural UP. The Free Drugs and Diagnostics initiatives have made a real difference—we see patients who earlier would have gone to quacks now coming to us. But the median OOPE of ₹11,285 is still a lot for families earning ₹5,000-10,000 a month. And yes, for specialized treatments, the costs escalate quickly. Good first step, but we need higher coverage limits under PM-JAY.
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