NSO's 80th round household health survey records median OOPE of ₹11,285 per hospitalisation and rural outpatient utilisation in public facilities up from 28% (2014) to 35% (2025).
Why in News
MoHFW, drawing on the National Statistical Office's (NSO, MoSPI) 80th round survey on Household Social Consumption: Health, released the latest findings on healthcare access, affordability and utilisation in late April 2026. The survey canvassed 1,39,732 households (76,296 rural + 63,436 urban) — comparable to the 75th round (2017-18) baseline. Key headlines: median Out-of-Pocket Expenditure (OOPE) per hospitalisation case is ₹11,285; for public hospitals it drops below ₹1,100 for over half the cases; OOPE for outpatient care in public facilities is effectively zero. Institutional deliveries climbed to 95.6% rural (vs 90.5% in 2017-18) and 97.8% urban. Rural outpatient utilisation of public facilities rose from 28% (2014) to 35% (2025).
At a Glance
- Conducted by
- National Statistical Office (NSO), under MoSPI; results released via MoHFW April 2026
- Survey
- 80th round on 'Household Social Consumption: Health'
- Sample
- 1,39,732 households — 76,296 rural + 63,436 urban; 75th round (2017-18) is baseline
- Median OOPE per hospitalisation case in 2025
- ₹11,285 across all facilities
- Median OOPE in public facility hospitalisations
- under ₹1,100 (more than half of cases)
- Median OOPE for outpatient care in public facilities
- effectively zero
- Institutional deliveries
- 95.6% rural (up from 90.5% in 2017-18); 97.8% urban (up from 96.1%)
- Government-facility share of deliveries
- 66.8% rural, 47% urban
- Rural outpatient public-facility share
- 28% (2014) → 35% (2025) — sustained shift
- PPRA (Proportion of Population Reporting Ailments)
- rural 6.8% → 12.2%; urban 9.1% → 14.9%
- Government health insurance coverage
- 45.5% rural, 31.8% urban (AB-PMJAY-led growth)
- Epidemiological transition
- NCDs (diabetes, cardiovascular) rising as infectious diseases decline
- AMRIT pharmacies
- 220+ across 29 States/UTs; 6,500+ drugs at up to 50% discount
- Ayushman Arogya Mandirs (AAMs)
- over 1.84 lakh operational across India
What the NSO 80th round survey covers
The 'Household Social Consumption: Health' is a periodic household survey conducted by the National Statistical Office (NSO) under MoSPI — historically run by the National Sample Survey Office (NSSO) and now under NSO after its 2019 reorganisation. Each round captures household-level healthcare expenditure, episodes of illness (acute and chronic), in-patient and out-patient utilisation, choice between public and private providers, insurance coverage and pre-natal/post-natal/maternal health indicators. The 80th round, released through MoHFW in April 2026 from a sample of 1,39,732 households (76,296 rural + 63,436 urban), is the first major refresh after the 75th round (2017-18 reference period). The headline policy frame is the shift toward Universal Health Coverage (UHC) — affordable access in public facilities plus insurance-led financial protection in private facilities under AB-PMJAY.
Affordability — OOPE collapsing in public care
Out-of-Pocket Expenditure (OOPE) is the dominant financial-burden indicator in Indian health economics, since high OOPE is the principal driver of health-induced poverty. The 80th round records median OOPE per hospitalisation case at ₹11,285 in 2025 across all facilities. For patients admitted to government health facilities, more than half incurred OOPE of under ₹1,100 — an order-of-magnitude lower than private care. For outpatient care in public facilities, average OOPE is effectively zero, reflecting the rollout of the Free Drugs Service Initiative (FDSI) and the Free Diagnostics Initiative (FDI) under the National Health Mission. AMRIT pharmacies (220+ across 29 States/UTs, 6,500+ drugs at up to 50% discount) and Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) generic stores extend this affordability shield.
Utilisation — public facilities gaining share
Rural outpatient use of public facilities rose from 28% in 2014 to 35% in 2025 — a 7-percentage-point structural shift attributed to expanded primary care under Ayushman Bharat Health & Wellness Centres (now Ayushman Arogya Mandirs, AAMs — 1.84 lakh+ operational), strengthened sub-centre/PHC infrastructure, and free-drugs/free-diagnostics convergence. Institutional deliveries rose to 95.6% (rural, vs 90.5% in 2017-18) and 97.8% (urban, vs 96.1%). 66.8% of rural deliveries now occur in government facilities (47% in urban) — driven by Janani Suraksha Yojana (JSY, conditional cash transfer for institutional delivery), Janani Shishu Suraksha Karyakaram (JSSK, free entitlements for pregnant women and newborns), and Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA, monthly assured antenatal care).
Health-seeking behaviour + the epidemiological transition
The Proportion of Population Reporting Ailments (PPRA) has nearly doubled between the 75th and 80th rounds — from 6.8% to 12.2% in rural areas and from 9.1% to 14.9% in urban — reflecting greater health awareness and proactive care-seeking, not just morbidity load. Government health insurance coverage rose to 45.5% (rural) and 31.8% (urban), with AB-PMJAY rural coverage growing from 12.9% to 45.5% — making PMJAY the largest publicly-funded health-assurance scheme globally by population covered. Disease pattern is shifting: infectious diseases declining, non-communicable diseases (diabetes, cardiovascular) rising — the classic epidemiological transition. This drives policy emphasis on community-based screening (VHSNCs, AAMs), tobacco-control, NPCDCS interventions, and lifestyle counselling.
Static GK
- •: MoSPI was formed in 1999 by merging the Department of Statistics and Department of Programme Implementation; the NSO was constituted in 2019 by merging NSSO and CSO.
- •: The 73rd round of the survey (Jan-June 2014) was the previous pre-2017 baseline; the 75th round covered Jul 2017 - Jun 2018.
- •: AB-PMJAY was launched on 23 September 2018 at Ranchi by PM Modi; it covers ~55 crore beneficiaries.
- •: PMBJP — Pradhan Mantri Bhartiya Janaushadhi Pariyojana — runs over 13,000 Jan Aushadhi Kendras as of 2026 selling generic medicines.
- •: JSY (2005) and JSSK (2011) are NHM conditional cash + entitlements schemes for institutional deliveries.
- •: PMSMA (2016) provides free antenatal care on the 9th of every month for pregnant women in their 2nd/3rd trimester.
- •: India's public health expenditure target under the National Health Policy 2017 is 2.5% of GDP by 2025.
- •: WHO defines catastrophic health expenditure as OOPE >10% of household consumption expenditure.
- •: NPCDCS — National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke — leads NCD response under NHM.
- •: Anaemia Mukt Bharat strategy operates within the larger Pradhan Mantri Surakshit Matritva Abhiyan framework.
Timeline
- 1999MoSPI formed by merger of Department of Statistics and Department of Programme Implementation
- 2005National Rural Health Mission (NRHM) and Janani Suraksha Yojana (JSY) launched
- 2011Janani Shishu Suraksha Karyakaram (JSSK) launched — free entitlements for pregnant women and newborns
- 2013National Urban Health Mission (NUHM) launched; NRHM + NUHM together form NHM
- 2016PMSMA (free antenatal care on 9th of every month) launched
- 2017-1875th round of NSS Household Health survey — current baseline for 80th round comparisons
- 2018Ayushman Bharat launched: HWCs + PMJAY (23 September, Ranchi)
- 2019NSO formed by merging NSSO and CSO; AMRIT chain expansion accelerates
- 2024HWCs renamed Ayushman Arogya Mandirs (AAMs)
- April 2026NSO 80th round 'Household Social Consumption: Health' survey released
- →80th round = Household Social Consumption: Health.
- →Sample: 1,39,732 households (76,296 rural + 63,436 urban).
- →Median OOPE/hospitalisation 2025: ₹11,285.
- →Public facility hospitalisation: half of cases <₹1,100.
- →Outpatient OOPE in public: median zero.
- →Institutional deliveries: 95.6% rural, 97.8% urban.
- →Govt facility delivery share: 66.8% rural, 47% urban.
- →Rural outpatient public share: 28% (2014) → 35% (2025).
- →PPRA: rural 6.8 → 12.2%; urban 9.1 → 14.9%.
- →Govt insurance: 45.5% rural, 31.8% urban.
- →AB-PMJAY rural cover: 12.9% → 45.5%.
- →AAMs: 1.84 lakh+; AMRIT: 220+ pharmacies, 29 states.
- →PM-JAY = ₹5 lakh/family/year cashless cover.
- →NHM = NRHM (2005) + NUHM (2013).
Exam Angles
NSO's 80th round Household Social Consumption: Health survey shows median OOPE per hospitalisation ₹11,285, near-zero in public outpatient care, institutional deliveries 95.6% rural.
Q1. Which Ayushman Bharat sub-component provides cashless secondary and tertiary care insurance of ₹5 lakh per family per year to poor and vulnerable families?
- A.Pradhan Mantri Jan Arogya Yojana (PM-JAY)
- B.Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
- C.Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP)
- D.Pradhan Mantri Suraksha Bima Yojana (PMSBY)
tap to reveal answer
Answer: A. Pradhan Mantri Jan Arogya Yojana (PM-JAY)
PM-JAY is the insurance arm of Ayushman Bharat, providing ₹5 lakh per family per year cashless secondary/tertiary cover for ~12 crore beneficiary families. PMSMA is the free antenatal-care campaign on the 9th of each month. PMBJP runs Jan Aushadhi generic-medicine stores. PMSBY is an accident-insurance scheme (₹2 lakh cover at ₹20/year) under the Jan-Dhan-Aadhaar-Mobile umbrella — not a healthcare-services scheme.
India's health-financing has historically been characterised by high OOPE (over 60% of total health expenditure as recently as 2010) and low public spending (~1.3% of GDP). The 2017 National Health Policy committed to raising public health spending to 2.5% of GDP by 2025 and operationalising UHC through Ayushman Bharat. The NSO 80th round provides the first comprehensive evidence base since the 2017-18 75th round on whether these policy bets are translating into real affordability and access gains.
- Public-facility utilisation has structurally shiftedThe 7-percentage-point rise in rural outpatient public-facility share (28% → 35%, 2014-25), near-doubling of PPRA, and growth of AB-PMJAY rural cover from 12.9% to 45.5% suggest a structural rather than cyclical shift toward public-system reliance. The combination of near-zero outpatient OOPE in public facilities (FDSI + FDI) and AAM expansion has made public care the rational first choice for primary needs.
- The NCD transition is straining a system optimised for infectious diseaseRising NCD burden (diabetes, cardiovascular, hypertension, cancer) demands long-horizon, continuity-of-care models — chronic medications, periodic screening, lifestyle counselling. India's primary-care network was historically calibrated for episodic infectious-disease treatment and maternal-child health. Bridging this gap requires AAM-level NCD screening (NPCDCS) integration, telemedicine continuity (eSanjeevani), and digital health records (ABDM).
- From access to quality and equityClosing access gaps must now move to closing quality and equity gaps: NQAS (National Quality Assurance Standards) certification of public facilities, hospital-acquired infection metrics, equity dashboards by SC/ST/poorest-quintile cuts, and integration of nutrition and WASH (water-sanitation-hygiene) into the AAM service basket. Public health spending also needs to credibly cross the 2.5% of GDP threshold to sustain these gains.