Latest NSO results show rise in health-seeking behaviour, relatively low out-of-pocket medical expenses

The National Statistical Office (NSO) has released findings from the 80th Round of the National Sample Survey (NSS) on Household Social Consumption on Health...

What Happened

The National Statistical Office (NSO) has released findings from the 80th Round of the National Sample Survey (NSS) on Household Social Consumption on Health, comparing health indicators between the 75th Round (2017-18) and the 80th Round (2025).
The survey documents a near-doubling of the Proportion of Population Reporting Ailments (PPRA): from 6.8% to 12.2% in rural areas and 9.1% to 14.9% in urban areas — interpreted as a positive sign of improved health awareness and willingness to seek treatment, not a deterioration in health status.
Government health scheme/insurance coverage expanded dramatically: from 12.9% to 45.5% in rural areas and from 8.9% to 31.8% in urban areas — a more than three-fold increase, primarily attributed to Ayushman Bharat PM-JAY.
The median out-of-pocket medical expenditure (OOPE) per hospitalisation stood at ₹11,285, indicating that in over half of all hospitalisations, relatively low expenditure is incurred; declining OOPE is most pronounced among the bottom two consumption quintiles.
The survey also records an epidemiological transition: decline in infectious diseases and a rise in non-communicable diseases (NCDs) such as diabetes and cardiovascular conditions.

Static Topic Bridges

National Statistical Office (NSO) and the National Sample Survey

The NSO, under the Ministry of Statistics and Programme Implementation (MoSPI), is India's apex statistical body. It conducts the National Sample Survey (NSS), a large-scale household survey series that has been running since 1950-51. NSS rounds focus on different subjects — consumer expenditure, employment, health, education — on a rotating basis. The Health and Morbidity rounds are particularly significant for tracking welfare outcomes. The 75th Round (2017-18) and 80th Round (2025) both focused on household social consumption on health.

NSO formed: 2019, by merging Central Statistics Office (CSO) and National Sample Survey Office (NSSO)
Ministry: MoSPI (Ministry of Statistics and Programme Implementation)
NSS has been conducted since 1950-51; each round runs for approximately one year
80th Round: focuses on Household Social Consumption on Health (2024-25)
Consumer Price Index (CPI) is also compiled by NSO/MoSPI

Connection to this news: The 80th Round is an NSO flagship survey; its findings on government health scheme coverage and OOPE form the primary evidence base for evaluating the real-world impact of schemes like Ayushman Bharat PM-JAY.

Ayushman Bharat — PM-JAY and Health & Wellness Centres

Ayushman Bharat is a flagship health programme with two components: (1) Pradhan Mantri Jan Arogya Yojana (PM-JAY) — the world's largest health assurance scheme, providing cashless hospitalisation coverage of ₹5 lakh per family per year for secondary and tertiary care to the bottom 40% of the population (~55 crore beneficiaries); and (2) Ayushman Bharat Health and Wellness Centres (AB-HWC, now Ayushman Arogya Mandirs) — converting sub-health centres and primary health centres into comprehensive primary care facilities targeting preventive and promotive health.

PM-JAY launched: September 23, 2018; nodal agency: National Health Authority (NHA)
Coverage: ₹5 lakh/family/year; ~55 crore beneficiaries (bottom 40% by SECC 2011 data)
AB-HWC target: 1.5 lakh Health and Wellness Centres across India
PM-JAY Budget 2026-27: ₹9,500 crore (5.56% increase); NHM Budget: ₹39,390 crore
PM-JAY estimated to have saved beneficiaries over ₹1.25 lakh crore in OOPE (Economic Survey 2024-25)

Connection to this news: The NSO 80th Round's finding of government health scheme coverage rising from 12.9% to 45.5% in rural areas directly reflects PM-JAY's penetration; the declining OOPE among lower quintiles quantifies PM-JAY's financial protection impact.

Out-of-Pocket Expenditure (OOPE) and Health Financing

Out-of-pocket expenditure (OOPE) refers to direct payments made by individuals to healthcare providers at the time of service use, excluding any prepayment (insurance, taxes). High OOPE is a key driver of catastrophic health expenditure and medical impoverishment — where households are pushed below the poverty line by health spending. India has historically had one of the highest OOPE ratios globally (constituting ~50-60% of total health expenditure). Reducing OOPE is a stated goal of the National Health Policy 2017 (target: reduce to 30% of total health expenditure by 2025).

National Health Policy 2017: target to reduce OOPE to 30% of total health expenditure
NHA estimates India's OOPE share at approximately 39.4% of Current Health Expenditure (CHE) as of 2021-22
Catastrophic health expenditure defined as OOPE exceeding 10% of household income (WHO threshold)
80th Round finding: median OOPE per hospitalisation = ₹11,285
Constitutional basis: Article 47 (DPSP) — State shall regard raising the level of nutrition and the standard of living and improve public health as primary duties

Connection to this news: The NSO 80th Round's finding of a declining OOPE trajectory — especially for lower quintiles — represents measurable progress towards the National Health Policy 2017 target and reflects the financial protection offered by PM-JAY.

Epidemiological Transition and Non-Communicable Diseases

Epidemiological transition refers to the shift in a country's disease burden from predominantly infectious/communicable diseases (like tuberculosis, malaria, diarrhoeal diseases) to non-communicable diseases (NCDs — diabetes, cardiovascular disease, cancer, chronic respiratory disease). India is in the midst of this transition, with NCDs now accounting for approximately 65% of total deaths. The NSO 80th Round documents a decline in infectious disease prevalence alongside a rise in NCDs, confirming this demographic-epidemiological shift.

NCDs account for ~65% of all deaths in India (WHO/ICMR estimates)
National Programme for Prevention and Control of Cancer, Diabetes, CVD and Stroke (NPCDCS): key government response
National Health Mission (NHM) — Non-Communicable Disease component addresses screening at Health & Wellness Centres
SDG 3.4: reduce premature mortality from NCDs by one-third by 2030

Connection to this news: The NSO 80th Round's documentation of rising NCD prevalence alongside falling infectious disease burden validates the epidemiological transition and signals the need for a re-orientation of India's public health infrastructure towards preventive NCD care.

Key Facts & Data

NSO 80th Round: Household Social Consumption on Health (2024-25); conducted by NSO under MoSPI
Proportion Reporting Ailments (PPRA) — rural: 6.8% (75th Round) → 12.2% (80th Round); urban: 9.1% → 14.9%
Government health scheme coverage — rural: 12.9% → 45.5%; urban: 8.9% → 31.8%
Median OOPE per hospitalisation: ₹11,285 (2025)
Public facility usage for outpatient care — rural: 28% (2014) → 35% (2025)
PM-JAY: ₹5 lakh/family/year cashless cover; ~55 crore beneficiaries; launched September 23, 2018
National Health Policy 2017 target: reduce OOPE to 30% of total health expenditure
Article 47 (Constitution): DPSP — State duty to improve public health and nutrition
NCDs: ~65% of all deaths in India; SDG 3.4 targets one-third reduction in premature NCD mortality by 2030