The National Statistical Office (NSO), Ministry of Statistics and Programme Implementation has conducted the survey on Household Social Consumption related to Health during the period July 2017 to June 2018 as a part of 75^th round of National Sample Survey (NSS). Prior to this, there have been three such surveys – carried out, in 1995-96 (52^nd round of NSS), 2004 (60^th round of NSS) and 2014 (71^st round of NSS).

2.         The main objective of the survey was to gather basic quantitative information on the health sector viz. morbidity, profile of ailments including their treatment, role of government and private facilities in providing healthcare, expenditure on medicines, expenditure on medical consultation and investigation, hospitalisation and expenditure thereon, maternity and childbirth, the condition of the aged, etc.

3.         The present survey was spread across the country and data were collected from 1,13,823 households (64,552 in rural areas and 49,271 in urban areas), covering 5,55,115 persons (3,25,883 in rural areas and 2,29,232 in urban areas), following a scientific survey methodology. Some important findings of the survey, based on the response of the households, are presented in the following paragraphs:

3.1       Percentage of persons that responded as ailing in a 15-day period:

1. 6.8% in rural India (6.1% for rural males and 7.6% for rural females).
2. 9.1% in urban India (8.2% for urban males and 10.0% for urban females).
3. 7.5% in India as a whole (6.7% for males and 8.3% for females).

3.2       Percentage of persons that responded as ailing in a 15-day period for specific age-groups:

1. 11.4% in the age-group 45-59 (9.3% among males and 13.6% among females).
2. 27.7% in the age-group 60+ (27.5% among males and 27.9% among females).

3.3       Proportion of persons treated as in-patient any time during a 365-day period:

1. 2.6% in rural India (2.6% for rural males and 2.7% for rural females).
2. 3.4% in urban India (3.4% for urban males and 3.5% for urban females).
3. 2.9% in India as a whole (2.8% for males and 2.9% for females).

3.4       Proportion of persons treated as in-patient (among persons aged 60+ ):

1. 7.7% in rural India (8.6% for rural males and 6.8% for rural females).
2. 10.2% in urban India (11.6% for urban males and 8.8% for urban females).
3. 8.5% in India as a whole (9.6% for males and 7.5% for females).

3.5       In-patient hospitalization (excluding childbirth) by type of hospital for availing treatment:

1. Public hospitals accounted for 42% (46% in rural areas, 35% in urban areas).
2. Private hospitals (excl. charitable, NGO-run) accounted for 55% (52% in rural areas, 61% in urban areas).
3. Charitable/trust/NGO-run hospitals accounted for 2.7% (2.4% in rural areas, 3.3% in urban areas).

3.6       Healthcare service provider for treatment of ailments:

1. Government hospitals in case of 30% ailments (33% in rural, 26% in urban).
2. Private hospitals in case of 23% ailments (21% in rural, 27% in urban).
3. Private doctors/clinics in case of 43% ailments (41% in rural, 44% in urban).
4. Informal health care provider and Charitable/trust/NGO-run hospitals in case of remaining 4.1% of ailments (5.2% in rural, 2.2% in urban).

3.7       Population with health expenditure coverage:

1. 14% of the rural population and 19% of the urban population reported that they had health expenditure coverage.
2. 13% of rural and 9% of urban population reported that they were covered by Government sponsored health insurance.
3. About 1% of rural population reported that they were covered by health insurance arranged by Government/PSU as employer/ Employer-supported health protection schemes.
4. About 6% of urban population reported that they were covered by health insurance arranged by Government/PSU as employer/ Employer-supported health protection schemes.
5. About 4% of urban population reported that they were covered by health insurance arranged by the households with insurance companies.

3.8       Treatment seeking behaviour:

1. In both rural and urban India, 95% of ailments were treated by allopathy.

3.9       Average medical expenditure per hospitalisation case (excluding childbirth):

1. Average medical expenditure per hospitalisation case (excluding childbirth) in rural India about Rs. 16,676 and Rs. 26,475 in urban India.
2. In Government/public hospitals the expenditure was about Rs. 4,452 (about Rs. 4,290 in rural and Rs. 4,837 in urban areas).
3. In private hospitals the expenditure was about Rs. 31,845 (about Rs. 27,347 in rural and Rs. 38,822 in urban areas).

3.10     Place of childbirth:

1. In rural areas about 90% childbirths were institutional (in Government/private hospitals) and in urban areas it was about 96%.
2. Among institutional childbirths in rural areas, about 69% were in Government hospitals and about 21% in private hospital.
3. Among institutional childbirths in urban areas, about 48% were in each of Government hospitals and private hospitals.

3.11     Hospital childbirth (including normal, caesarean and other type of delivery) and surgery:

4. Surgery was done in about 28% of hospital childbirths in India (rural: about 24%; urban: about 41%).
5. In Government hospitals, only about 17% of childbirths were surgery cases – over 92% were provided free.
6. In private hospitals, about 55% of childbirths were surgery cases – only 1% was provided free.
7. The average expenditure per hospital childbirth was about Rs. 2,404 in rural and Rs. 3,106 in urban areas for Government hospitals. It was about Rs. 20,788 in rural and Rs. 29,105 in urban for private hospitals.
8. For a normal delivery, average expenditure per childbirth in a Government hospital was about Rs. 2,084 in rural and Rs. 2,459 in urban India.
1. For a normal delivery, average expenditure per childbirth in a private hospital was about Rs. 12,931 in rural and Rs. 17,960 in urban areas.
10. For a caesarean delivery, average expenditure in a Government hospital was around Rs. 5,423 in rural and Rs. 5,504 in urban areas.
11. For a caesarean delivery, average expenditure in a private hospital was around Rs. 29,406 in rural and Rs. 37,508 in urban areas.

3.12     Immunisation among children aged 0-5 years:

1. About 97% of both boys and girls had received vaccination in rural India.
2. About 98% of boys and 97% of girls had received vaccination in urban India.
3. About 59% of boys and 60% of girls at all-India level had been fully immunised (i.e., received all 8 prescribed vaccinations).
4.  About 82% of males and 47% of females of 60 years and above were living with their spouses.
5. About 94% of males and 91% of females of 60 years and above were physically mobile.

4.         The “Key Indicators of Household Social Consumption in India: Health” and unit level data are both available on www.mospi.gov.in.

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VRRK/VJ/NK