India’s healthcare system is showing signs of significant transformation, with improved access, reduced costs, and stronger public health utilisation, according to the latest findings from the National Statistical Office (NSO), 80th Round Survey on Household Social Consumption: Health.
Released on April 29, 2026, the large-scale survey, covering over 1.39 lakh households across rural and urban India, offers one of the most comprehensive snapshots of how Indians access and pay for healthcare. The findings point to a notable shift: more people are seeking care, public health facilities are being used more frequently, and financial barriers appear to be easing.
At a time when rising healthcare costs are a global concern, India’s data suggests a different trend, especially in public healthcare, where essential services are increasingly accessible at little to no cost. The survey also highlights expanding insurance coverage and improved maternal health outcomes, reflecting years of policy interventions and increased public investment.
Experts say these changes indicate not just better infrastructure, but growing trust in the public healthcare system. Here’s a closer look at what the NSO survey reveals about healthcare access, affordability, and utilisation in India.
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Healthcare becoming more affordable
One of the most striking findings of the survey is the low median out-of-pocket expenditure (OOPE) for healthcare. The median OOPE per hospitalisation case in 2025 stands at Rs 11,285, indicating that more than half of hospitalisation cases involve relatively modest spending. Importantly, for hospitalisations in public health facilities, the median OOPE drops sharply to Rs 1,100.
Even more notable is outpatient care, median OOPE in public facilities is zero, meaning a large proportion of patients access care without paying out of pocket. This aligns with initiatives like the Free Drugs Service Initiative (FDSI) and Free Diagnostics Initiative (FDI), which aim to provide essential medicines and tests at no cost.
Rising healthcare access and utilisation
In rural areas, outpatient care utilisation in public facilities rose from 28% in 2014 to 35% in 2025. This growth is linked to the expansion of primary healthcare through over 1.84 lakh Ayushman Arogya Mandirs, which provide preventive, promotive, and curative services closer to communities. Increased utilisation suggests improved accessibility, but also greater trust in government-run facilities.
Health-seeking behaviour improves
Another key indicator is the rise in the Proportion of Population Reporting Ailments (PPRA).
Between 2017-18 and 2025:
- Rural PPRA increased from 6.8% to 12.2%
- Urban PPRA rose from 9.1% to 14.9%
This near doubling suggests that more people are recognising symptoms and seeking medical care, an important shift toward proactive health behaviour.
Insurance coverage expands significantly
Financial protection has improved dramatically with the expansion of government-backed insurance schemes.
Coverage has more than tripled:
- Rural areas: 12.9% to 45.5%
- Urban areas: 8.9% to 31.8%
Schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana have played a central role in reducing catastrophic healthcare spending.
Targeted impact on poorer households
The survey shows a decline in out-of-pocket expenditure among the bottom two consumption quintiles, indicating that lower-income groups are benefiting the most from government interventions. This suggests improved equity in healthcare access, an important goal in public health policy.
Maternal healthcare sees strong gains
India has made notable progress in maternal health outcomes.
Institutional deliveries have increased to:
- 95.6% in rural areas
- 97.8% in urban areas
This reflects the success of programmes such as:
- Janani Suraksha Yojana (JSY)
- Janani Shishu Suraksha Karyakram (JSSK)
- Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
Shift in disease patterns
The survey also captures an epidemiological transition:
- Decline in infectious diseases
- Rise in non-communicable diseases (NCDs) like diabetes and heart disease
This trend aligns with global patterns highlighted by the Global Burden of Disease Study, which shows increasing NCD prevalence in developing countries.
The shift underscores the need for:
- – Preventive care
- – Early screening
- – Long-term disease management
- – Strengthening healthcare infrastructure
Improved outcomes are linked to sustained government investment in:
- – Primary, secondary, and tertiary healthcare infrastructure
- – Human resources
- – Digital health systems
Initiatives like AMRIT pharmacies, offering discounted medicines, and improved diagnostic networks have enhanced affordability and access.
The NSO 80th Round Survey paints a largely positive picture of India’s healthcare landscape, one marked by improved access, reduced financial burden, and expanding insurance coverage. Increased utilisation of public health facilities and rising health-seeking behaviour suggest growing trust in the system. However, the shift toward non-communicable diseases also signals new challenges that will require sustained focus on prevention and long-term care. As India moves closer to universal health coverage, these findings highlight both the progress made and the work that lies ahead.
However, despite these positive developments, several structural and emerging challenges continue to shape the future of India’s healthcare system. One of the major concerns is the growing burden on public hospitals due to rising patient inflow. As more people begin to trust and depend on government healthcare facilities, especially in rural and semi-urban regions, there is increasing pressure on existing infrastructure, medical staff, and resources. Long waiting hours, shortage of specialist doctors, and uneven distribution of healthcare services across states remain important issues that need sustained policy attention.
Another area that requires focus is the healthcare workforce. India still faces shortages of trained doctors, nurses, and paramedical staff, particularly in rural areas where healthcare access is most critical. While infrastructure has expanded significantly, the effectiveness of healthcare delivery depends equally on the availability of skilled human resources. Strengthening medical education, increasing rural healthcare incentives, and improving working conditions for healthcare professionals can play a crucial role in addressing these gaps.
Digital healthcare is also emerging as an important component of India’s health system transformation. Platforms such as telemedicine services, digital health records, and online consultations are helping bridge geographical barriers and improve access to healthcare in remote areas. The expansion of digital health initiatives under the Ayushman Bharat Digital Mission reflects the government’s attempt to modernise healthcare delivery and create a more connected healthcare ecosystem. If implemented effectively, digital health technologies can improve efficiency, reduce delays, and support better disease monitoring and management.
At the same time, the rise of non-communicable diseases demands a shift from treatment-focused healthcare to preventive healthcare. Lifestyle-related illnesses such as diabetes, hypertension, obesity, and cardiovascular diseases are becoming increasingly common due to changing dietary habits, stress, lack of physical activity, and urbanisation. Addressing these conditions will require greater public awareness campaigns, regular health screenings, promotion of healthy lifestyles, and stronger community-level healthcare systems. Preventive healthcare can significantly reduce the long-term economic and social burden of diseases on both families and the healthcare system.
Healthcare financing will also remain a key factor in sustaining progress toward universal health coverage. Although insurance coverage has expanded considerably, ensuring quality healthcare services for a large population requires continuous public investment. Increased budgetary allocation to healthcare, especially in primary healthcare and rural infrastructure, will be essential to maintain affordability and accessibility. Effective monitoring of healthcare schemes and reducing regional disparities in healthcare outcomes will further determine the success of India’s healthcare reforms.
Overall, the NSO 80th Round Survey highlights a period of meaningful progress in India’s healthcare sector. The findings suggest that policy initiatives aimed at affordability, accessibility, and financial protection are producing visible results. Greater utilisation of public healthcare services, improved maternal health indicators, and wider insurance coverage indicate that healthcare is becoming more inclusive and accessible for millions of people. At the same time, evolving disease patterns and infrastructure challenges underline the need for continuous reforms and long-term planning. Moving forward, India’s healthcare system will need to balance expansion with quality, strengthen preventive healthcare, and ensure equitable access for all sections of society to achieve sustainable and comprehensive public health development.
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