Household Social Consumption: Health is a National Sample Survey that collects household-level data on health status, healthcare use and medical expenditure in India.
It is conducted by the National Statistics Office, Ministry of Statistics and Programme Implementation. The latest survey was conducted during January–December 2025 as part of the 80th Round of NSS, and its findings were released in April 2026.
What the Survey Measures
The survey provides data on:
- morbidity, or persons reporting ailments
- hospitalisation
- type of ailment
- use of public and private healthcare facilities
- childbirth and maternal care
- health insurance coverage
- out-of-pocket medical expenditure
- rural-urban differences in healthcare access
- household burden of treatment costs
It is one of India’s most important health-data sources because it captures healthcare from the household perspective, not only from hospitals or government records.
Coverage and Sample
The 2025 survey covered rural and urban India, except difficult-to-access villages in the Andaman and Nicobar Islands. It surveyed 17,520 first-stage units, including 9,575 villages and 7,945 urban blocks. The total number of households surveyed was 1,39,732, including 76,296 rural households and 63,436 urban households.
Latest Findings
Morbidity and Hospitalisation
- About 13.1% of persons reported suffering from some ailment, including chronic ailments, during the previous 15 days in 2025.
- In the previous NSS health survey of 2017–18, this figure was 7.5%.
- The reported illness rate was higher among the elderly.
- The hospitalisation rate was about 2.9% during the previous 365 days.
- Hospitalisation was highest among persons aged 60 years and above, at 8.1%.
- Among young children, the 0–4 age group had the highest hospitalisation rate at 3.4%.
This rise in reported ailments should not be read only as worsening health. It may also indicate better diagnosis, greater awareness and higher reporting of chronic diseases.
Disease Pattern
The survey shows a shift in India’s disease profile.
- Infectious diseases declined compared to the 2017–18 survey.
- Non-communicable diseases such as hypertension, diabetes and thyroid disorders increased.
- Infections and respiratory ailments were more common among children and adolescents.
- Cardiovascular and endocrine/metabolic diseases were more frequent after the age of 30.
- Hypertension and diabetes were major contributors among lifestyle-related diseases.
This confirms India’s ongoing epidemiological transition from infectious diseases towards chronic and lifestyle-related illnesses.
Childbirth and Maternal Care
The survey shows major progress in institutional childbirth.
- 96.2% of childbirths during the previous 365 days took place in institutions.
- Rural institutional deliveries stood at 95.6%.
- Urban institutional deliveries stood at 97.8%.
- Home deliveries were only 3.8% nationally.
- Antenatal care coverage was nearly universal at around 98%.
- Postnatal care was 92% in rural areas and 95% in urban areas.
This reflects the impact of schemes such as Janani Suraksha Yojana, Janani Shishu Suraksha Karyakram, Ayushman Bharat, National Health Mission and wider institutional delivery infrastructure.
Health Insurance Coverage
Health insurance coverage has expanded sharply.
- In 2017–18, health insurance coverage was 14.1% in rural areas and 19.1% in urban areas.
- By 2025, it increased to 47.4% in rural areas and 44.3% in urban areas.
- Government-sponsored schemes account for the majority of enrolments.
This is important because it shows the growing reach of publicly supported health-financing schemes. However, insurance coverage does not automatically mean full financial protection because outpatient care, medicines, diagnostics and exclusions may still create household expenditure.
Out-of-Pocket Medical Expenditure
Out-of-pocket expenditure remains a major concern.
- Average out-of-pocket medical expenditure per hospitalisation case, excluding childbirth, was ₹34,064.
- Rural average expenditure was ₹31,484.
- Urban average expenditure was ₹38,688.
- Median expenditure was much lower at ₹11,285, showing that some high-cost cases raise the average sharply.
The difference between public and private facilities is significant:
- Average hospitalisation expenditure in government/public facilities was ₹6,631.
- Average expenditure in private hospitals, including government-empanelled private hospitals, was ₹50,508.
- Median expenditure in public facilities was ₹1,100, while in private hospitals it was ₹24,000.
For outpatient care during the previous 15 days:
- Average out-of-pocket expenditure was ₹861.
- Rural average was ₹847.
- Urban average was ₹884.
- Median expenditure was around ₹400.
Public vs Private Healthcare Use
The survey indicates continued dependence on both public and private healthcare.
- Rural residents used government hospitals/public facilities for outpatient treatment more often than urban residents.
- Government/public facilities accounted for 35% of rural outpatient care and 25% of urban outpatient care.
This shows that public facilities remain especially important for rural healthcare access, while urban healthcare continues to rely more heavily on private providers.
Significance
The survey is important because it provides evidence for health policy beyond administrative claims.
It helps assess:
- progress in institutional deliveries
- expansion of health insurance coverage
- financial burden of hospitalisation
- public-private differences in treatment cost
- disease transition towards NCDs
- rural-urban gaps in healthcare access
- need for stronger primary healthcare
- effectiveness of health-financing schemes
The 2025 survey is especially useful because it updates the earlier 2017–18 NSS health data and gives a more current picture of India’s post-pandemic health system.
Policy Relevance
The survey points to several governance priorities:
- strengthen primary healthcare for early detection of NCDs
- reduce out-of-pocket expenditure, especially in private care
- improve public hospital quality and availability
- expand coverage of diagnostics and medicines
- improve outpatient-care support, not only hospitalisation insurance
- strengthen elderly care due to higher morbidity and hospitalisation among senior citizens
- integrate diabetes, hypertension and thyroid screening into routine care
- improve rural access while addressing urban private-care costs
Key Concerns
- Health insurance coverage has increased, but household spending remains high.
- Private hospitalisation is far costlier than public hospitalisation.
- NCDs are rising, requiring long-term and continuous care.
- Elderly people show higher illness and hospitalisation burden.
- Outpatient expenditure remains important but is often weakly covered by insurance.
- Rural-urban differences persist in access and provider choice.
- Higher reported morbidity may reflect both better awareness and growing chronic disease burden.
Conclusion
The NSS 80th Round Household Social Consumption: Health survey is a crucial source for understanding India’s health system from the household side. The latest 2025 data shows strong progress in institutional deliveries and health insurance coverage, but also highlights continuing concerns over out-of-pocket expenditure, private healthcare costs and the rising burden of non-communicable diseases.
Its core message is clear: India has improved access to healthcare, but financial protection and chronic disease management remain major policy challenges.
