Who uses public healthcare in India? Insights from NSS 75th round

Abstract

Indian healthcare comprises of both public and private healthcare providers. This study explores the patterns of utilisation of government hospitals across Indian states and examines the underlying reasons for not utilising by drawing the data from 75^th round of National Sample Survey (2017-18). Despite the availability of the free and subsidised services, the utilisation of government health facility is merely 30 percent of the population who seeks medical care, with higher usage in rural area. The concentration index reveals that public healthcare is utilised more by the poor and the inequality in utilisation is lower in the states with the strong public health system. The findings reveal that even though the utilisation of government health facility is higher for the poor, people across the income group, there is higher preference for non-government health facilities. Key reason cited for not utilising government health facilities include unsatisfactory low quality of services, long waiting time, issue of accessibility and preference for the trusted doctor/hospital. While the social and economically backward groups are more likely to use government health facilities, the preference for the non-government healthcare remains strong across the population. These findings suggest to invest more on government healthcare; and highlights the need to improve the infrastructure and service delivery in public healthcare.