Public or Private? An Analysis of the Healthcare Facility Choice in India

India’s healthcare system is increasingly dominated by private providers, raising the question of what drives this reliance and how different factors interact. Existing research points to quality gaps, accessibility issues, and socioeconomic inequalities, but much of it has lacked nationally representative evidence. Using microdata from the National Sample Survey (NSS) 75th Round, 2017–18, alongside secondary literature, this study examines household patterns of public versus private healthcare use. Weighted analysis reveals consistent trends: concerns about quality, doctor availability, and trust push patients toward private providers, while public facilities serve poorer households disproportionately. Private hospital preference rises with income, education, age, and is higher among women and upper-caste groups. Financing patterns show around 80% of households depend on income or savings, rural families more often borrow, and insurance coverage remains low (14.1% rural, 19.1% urban). Out-of-pocket spending still accounts for nearly half of national health expenditure. These findings highlight the urgent need for policies that rebuild confidence in public care while reducing financial vulnerability.