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Hospitalisation more privatised, costlier in India despite wider govt insurance coverage

The cost of private healthcare has increased at a much greater pace than of public health care, says the data released by National Statistical Office.

Updated on: Apr 21, 2026, 07:59:43 IST
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Hospitalisation has become more privatised and expensive in India between 2017-18 and 2025 even as more Indians are being covered by government-sponsored health insurance programmes, government data released on Monday showed.

Hospitalisation has become more privatised in India, says govt data. (Representational image)
Hospitalisation has become more privatised in India, says govt data. (Representational image)

An average non-childbirth hospitalisation in India required an out-of-pocket (OOP) spending of 34,604 in 2025. This number, about 1.64 times an average Indian household’s monthly spending in 2023-24, underlines the potential economic shock that a family could face from an emergency health spend.

nso health spending chart

These numbers are from the report on Household Social Consumption: Health, released by the National Statistical Office (NSO) on Monday, which is based on a survey of 139,732 households in the calendar year 2025.

Also Read | Why India’s health care problem begins before the hospital

The average OOP spending on medical costs – it includes costs of doctor’s fee, diagnostic tests, bed charges, appliances, blood, oxygen, etcetera, but not transport and food – for a treatment was 34,604 for hospitalisation (excluding childbirth), 14,755 for childbirth and 861 for non-hospitalisation cases.

These headline numbers hide a large divergence between the costs of availing government and private healthcare in the country. The private hospital-public health facility ratio of OOP spending on hospitalisation (excluding childbirth) was 7.6 in 2025 as against 6.8 in 2017-18 ( according to the same survey conducted in July 2017-June 2018). Similarly, for outpatient treatment, the ratio of private hospitals and private doctor/clinic with public health facilities was 5 and 3.3 in 2025, respectively, compared to 3.4 and 1.9 in 2017-18.

Private hospitalisation grows as public share drops in rural, urban India

Not only did private hospitalisation become more expensive, it also became more widespread. The share of hospitalisation cases (excluding childbirth) at public health facilities decreased from 45.7% in 2017-18 to 39.2% in 2025 in rural areas; and from 35.3% to 32.2% in urban areas.

To be sure, non-hospitalisation treatment in public facilities saw a marginal rise from 33% to 35% in rural areas but a fall from 26% to 25% in urban areas during this period.

The result of private hospitalisation becoming more expensive and widespread has been OOP spending outpacing not just overall but also health inflation in the country between 2017-18. OOP spending on hospitalisation excluding childbirth, childbirth and non-hospitalisation treatments increased by 1.88, 2 and 1.42 times between 2017-18 and 2025. Health spending as seen in the 2011 CPI series increased by 1.52 times while overall CPI increased by 1.43 times during this period.

The disproportionate rise in OOP spending –reimbursements from insurance are subtracted to arrive at this number – has happened despite a big growth in people covered by health insurance or schemes. The proportion of people covered by health insurance/financing schemes increased from 14.1% in 2017-18 to 47.4% in rural areas; and from 19.1% to 44.3% in urban areas. Most of this growth was due to government-sponsored schemes. The share covered by government sponsored schemes increased from 12.9% in 2017-18 to 45.5% in rural areas; and from 8.9% to 31.8% in urban areas.

 
ABOUT THE AUTHOR
Abhishek Jha

Abhishek Jha is Assistant Editor-Data at Hindustan Times. He uses statistical programming to generate newsworthy insights from large datasets. He is part of the team that produces Number Theory, a daily data story feature of the paper’s print edition. Since March 2024, he has been writing Weather Bee, a weekly column for the Hindustan Times website. He is a chemical engineer by training, who specialises in stories related to weather, climate, and the environment. Jha has been at HT since 2018, where he offers data-driven perspective and analysis on politics, environment, weather, climate, economy and society. His work includes data coverage of elections in India and abroad, including the 2019 and 2024 Lok Sabha elections; the disasters and extreme weather resulting from changing climate, such as floods, droughts, heat waves, cold waves, and dwindling snow cap in the Himalayas; the factors that drive poor air quality in northern India; the changing patterns of land use; the Covid-19 pandemic and its impact on labour market conditions; the changing pattern of consumer spending seen in the new consumer spending surveys; and social norms seen in the surveys such as the National Family Health Survey.

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