Key Details
Indicator | 2022–23 Baseline | What It Indicates |
|---|---|---|
Government Health Expenditure (GHE) | 43.72% of THE | Public health spending overtakes household expenditure |
Out-of-Pocket Expenditure (OOPE) | 43.41% of THE | Household medical burden reaches historic low |
OOPE (2014–15) | 62.6% of THE | Significant decline in household exposure over time |
Total Health Expenditure (THE) | ₹8,81,359 crore | Equals 3.37% of GDP |
Per Capita Health Spending | ₹6,373 | National average health expenditure |
Current Health Expenditure (CHE) | ₹7,66,814 crore (87%) | Immediate medical consumption spending |
Capital Expenditure | ₹1,14,545 crore (13%) | Health infrastructure and asset creation |
Public Health Spending | ₹3,85,332 crore | 1.48% of GDP |
State Government Share of GHE | 63.7% | States remain principal public financiers |
Private Health Insurance | 9.19% of THE | Growing role of pooled private financing |
Primary Healthcare Share | 46% | Largest expenditure priority |
Private General Hospitals | 30.77% of CHE | Largest provider category |
Summary
The National Health Systems Resource Centre (NHSRC) has released the tenth edition of the National Health Accounts (NHA) Estimates for India (2022–23), developed under the National Health Accounts Guidelines for India (2016) and aligned with the international System of Health Accounts 2011 (SHA 2011) framework.
The report establishes a major shift in India’s health financing structure.
For the first time, Government Health Expenditure (GHE)—measured at 43.72 percent of Total Health Expenditure (THE)—has overtaken household Out-of-Pocket Expenditure (OOPE), which declined to 43.41 percent of THE. This marks a significant change from 2014–15, when OOPE accounted for 62.6 percent of total national health spending, indicating a substantial reduction in household dependence on direct medical payments.
The NHA estimates India’s Total Health Expenditure (THE) for 2022–23 at ₹8,81,359 crore, equivalent to 3.37 percent of GDP and translating to a per capita expenditure of ₹6,373.
This expenditure is divided into two broad streams.
Current Health Expenditure (CHE)—covering immediate medical consumption such as treatment, medicines, diagnostics, and clinical services—accounts for ₹7,66,814 crore, representing 87 percent of THE. Meanwhile, Capital Expenditure, amounting to ₹1,14,545 crore (13 percent), supports longer-term infrastructure creation including medical colleges, hospitals, and diagnostic systems.
The report also highlights the continuing fiscal importance of state governments within India’s public health architecture. States contribute 63.7 percent of total public health expenditure, while the Union Governmentaccounts for the remaining 36.3 percent.
Beyond financing sources, the NHA provides a detailed picture of where healthcare spending is directed.
Across provider categories, private general hospitals absorb the largest share of Current Health Expenditure at 30.77 percent, followed by retail pharmacies (21.19 percent) and government general hospitals (15.69 percent).
From a functional perspective, inpatient curative care accounts for 25.72 percent of expenditure, while outpatient care represents 16.07 percent.
The level-of-care distribution reveals that primary healthcare remains India’s largest spending priority, receiving 46 percent of combined expenditures, followed by secondary care (34 percent), with tertiary care accounting for the remaining share.
The estimates additionally record a private health insurance contribution of 9.19 percent of THE, amounting to ₹81,012 crore, while drawing upon integrated data systems—including HCES 2022–23 and insurance datasets—to improve expenditure estimation and reduce statistical blind spots.
What is “Out-of-Pocket Expenditure” (OOPE)?
Out-of-Pocket Expenditure (OOPE) refers to the direct payments households make to healthcare providers at the point of service delivery, including spending on consultations, medicines, diagnostics, and hospital care.
Unlike insurance or publicly financed healthcare, OOPE places the full financial burden on individuals during illness. High OOPE levels can push vulnerable households into financial distress or poverty. Reducing OOPE is therefore considered a key objective within Universal Health Coverage (UHC) systems because it spreads health risks across pooled public or insurance financing mechanisms.
Policy Relevance
The 2022–23 National Health Accounts indicate a gradual transition toward a more publicly financed and risk-pooled healthcare system, reducing dependence on direct household expenditure while strengthening evidence-based health planning.
Strengthens Financial Protection Through Public Risk Pooling: The decline of Out-of-Pocket Expenditure (OOPE)to 43.41 percent of Total Health Expenditure—down from 62.6 percent in 2014–15—suggests that expanding public financing and insurance mechanisms may be reducing household exposure to catastrophic medical spending and financial distress.
Reinforces the Strategic Importance of Primary Healthcare: With primary healthcare accounting for 46 percent of combined expenditure, the estimates support continued investment in preventive and community-based care systems that can reduce downstream pressure on hospitals and specialized treatment facilities.
Raises Questions Around Provider Pricing and Healthcare Costs: The concentration of 30.77 percent of Current Health Expenditure within private general hospitals, alongside 21.19 percent flowing through retail pharmacies, highlights the continuing importance of pricing oversight, medicine affordability, and healthcare market regulation.
Highlights the Value of Integrated Health Data Systems: The incorporation of datasets such as HCES 2022–23 and insurance records demonstrates how stronger expenditure accounting and data triangulation can support more targeted budgeting, infrastructure planning, and health-system monitoring.
Follow the Full Report Here: National Health Systems Resource Centre: National Health Accounts Estimates for India (2022-23) Official Report