Utilization of health care services in public and private healthcare in India: Causes and determinants

Objective: Despite several government initiatives aimed at improving public healthcare services, private-sector has been a dominant player in most of the Indian states. Limited evidence is available on the factors that influence the choice of using public or private health services, which assume significance in the present context, when the government is willing to purchase care from the private providers. This subject is further explored in the paper by using the 71st round of National Sample Survey, ‘Key Indicators of Social consumption in India Health’, 2014.Data sources/study setting: The analysis included 15 major states of India, dividing them into three groups: low-, middle- and high-income, using average GSDP per capita. We further used multi-variate regression to examine the factors explaining the utilization of either public or private facility.Findings and conclusion: The utilization of public facilities for outpatient and inpatient services was found to be very low, except Assam and Odisha, which attributed to the poor quality of care and long waiting hours. Caste, education and wealth quintiles were the main factors explaining the choice of either public or private facility and strength of association between socio-economic variables and their utilization that varied across 3-categories of states.