NSO survey: Healthcare access and insurance coverage surge

 

The findings from the National Statistical Office (NSO) 80th Round Household Consumption: Health survey highlighted a significant increase in healthcare access across the country, supported by targeted Government interventions, expansion of public health services, and increased insurance coverage.

Covering both rural and urban areas across the country, the survey canvassed 1,39,732 households, including 76,296 in rural areas and 63,436 in urban areas, thereby offering robust and ground-level insights into healthcare access, affordability, and utilisation patterns.

The findings of the NSO 80th round are underpinned by the Government’s sustained increase in public investment in the health sector over the years, the health ministry said in a statement.

Enhanced budgetary allocations have enabled significant expansion of healthcare infrastructure across primary, secondary, and tertiary levels, strengthened human resources, and supported the scaling up of key initiatives focused on preventive, promotive, and curative care, the statement said.

The median out-of-pocket medical expenditure (OOPE) per hospitalisation case in 2025 was Rs 11,285, indicating that over half of the country’s hospitalisations involve relatively low expenditure. The report stated that only a small number of high-cost cases push up the average (mean value).

This shows that high expenditure is not widespread but limited to specific cases requiring specialised treatment. Moreover, the OOPE in more than half of the entire hospitalisation cases in public health facilities incur only Rs 1,100, the report said.

Importantly, for non-hospitalisation (outpatient) care, the median OOPE in public health facilities is zero, reflecting that a large proportion of citizens can access essential healthcare services entirely free of cost, it stated.

The Government’s Free Drugs Service Initiative (FDSI) and Free Diagnostics Initiative (FDI), launched in 2015, have ensured the availability of free medicines and diagnostic services to people even in the remotest areas of the country.

This paradigm shift in primary and essential healthcare accessibility is also aided by over 1.84 lakh Ayushman Arogya Mandirs (AAMs) situated across the country, which significantly expands the scope of comprehensive primary healthcare, the statement said.

These centres are also leveraging digital health innovations to improve access. Strengthening diagnostics through the in-house hub-and-spoke model with sample transportation has improved the accessibility and availability of diagnostic services across different healthcare tiers.

Further, the Affordable Medicines and Reliable Implants for Treatment (AMRIT) initiative, which has over 220 pharmacies across 29 States and Union Territories, provides more than 6,500 drugs at discounts of up to 50 per cent on market rates, significantly improving treatment affordability, the statement said.

These gains have been further reinforced by Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) and other targeted Government interventions, which have enhanced access, reduced financial barriers, and strengthened trust in public healthcare systems, it said.

Encouragingly, this enhanced affordability has coincided with a substantial increase in healthcare demand.

The Proportion of Population Reporting Ailments (PPRA) has nearly doubled between the 75th and 80th rounds from 6.8 per cent to 12.2 per cent in rural areas and from 9.1 per cent to 14.9 per cent in urban areas, signalling improved awareness and a decisive shift towards proactive health-seeking behaviour, the survey report said.

The survey also captured an important epidemiological transition, with a decline in infectious diseases and a rising prevalence of non-communicable diseases such as diabetes and cardiovascular conditions.

This reflects the impact of sustained Information, Education and Communication (IEC) efforts, intersectoral convergence through community-based platforms such as Village, Health, Sanitation and Nutrition Committees (VHSNCs), and large-scale screening initiatives at the primary care and community levels.

In response to rising demand, utilisation of public healthcare facilities has strengthened, particularly for outpatient care in rural areas, where utilisation has increased from 33  to 35 per cent. This improvement is attributable to the expansion of comprehensive primary healthcare services, with an emphasis on preventive, promotive, and early diagnostic care, supported by the availability of free drugs and diagnostics. 

Financial risk protection has expanded significantly with the rapid scaling up of Government-financed health insurance coverage, including under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) and various State schemes. 

The percentage of the population covered under these Government health-financed/insurance schemes in the country has increased 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, representing more than a threefold expansion. 

This marks a major milestone in safeguarding vulnerable populations against catastrophic health expenditures and advancing equity in healthcare access, the statement said. 

Further reinforcing this trend, granular household-level data reveal a declining trajectory of out-of-pocket expenditure among the bottom two consumption quintiles. This demonstrates that economically weaker sections are deriving the greatest benefit from Government interventions, it stated.

The survey also highlighted continued progress in maternal and child health outcomes, with institutional deliveries.