Improved Healthcare Access, Reduced Lower Out-Of-Pocket Expenses: Findings From NSO Survey

Access to healthcare has improved in India, whereas the out-of-pocket costs have reduced, finds the latest survey on Household Social Consumption on Health by the National Statistical Office (NSO). The findings show that access to healthcare facilities has improved significantly because of targeted intervention by the government, growing public health services, and increased insurance coverage. According to the survey, the out-of-pocket medical expenditure (OOPE) for hospitalisation in 2025 was Rs 11,285, whereas in public health facilities, the OOPE was only Rs 1,100 for more than half of the hospitalisation cases.

The survey highlights that only a small number of cases, which need specialised treatment, push up the average cost.

Notably, the median OOPE for non-hospitalisation care (outpatient) in public healthcare facilities has been recorded as Zero, indicating that citizens don’t have to pay anything from their pocket for getting OPD services. The survey finds that the Free Drugs Service Initiatives (FDSI) and Free Diagnostic Initiatives (FDI), which were launched in 2015, are the primary reasons behind lower OPD-related expenses. Under this initiative, free medicines and diagnostic tests are made available even in the remotest regions.

Further, the 1.84 lakh Ayushman Arogya Mandir (AAM), which also provides primary and essential healthcare, is also aiding in healthcare accessibility. These centres across the country support expanding the scope of preventive, promotive, and curative services and bringing them closer to people.

The survey also captures the surge in financial risk protection. As the government-financed health insurance coverage 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, reflecting a threefold growth in the coverage under government schemes, the economically weaker section has benefited the most.

Programmes like Affordable Medicines and Reliable Implants for Treatment (AMRIT), which provide 6,500 drugs at discounts of up to 50 per cent through more than 220 pharmacies across India, have also aided in improving healthcare affordability.

Interestingly, the Proportion of Population Reporting Ailments (PPRA) has almost doubled from 6.8 per cent to 12.2 per cent in rural areas and from 9.1 per cent to 14.9 per cent since 2017-18. It shows improved awareness among people and a shift in the proactive health-seeking behaviour.

This survey noted the increase in awareness of maternal health as well, where nearly two-thirds of rural deliveries occur in government facilities. The institutional deliveries have soared from 90.5 per cent in 2017-18 to 95.6 per cent in rural areas in 2025 and from 96.1 per cent to 97.8 per cent in urban centres.

This was the 80th round of the NSO survey, conducted on 1,39,732 households, including 76,296 in rural areas and 63,436 in urban areas, across the country. The findings show the increasing trend of using public health facilities over the last three rounds. As per the survey, in 2014, around 28 per cent of the rural population used public health facilities, which surged to 35 per cent in 2025.