Trends and Differentials in Health Care Utilization Pattern in India

Abstract

The results from this study indicate that a vast majority of people (almost 80 per cent) in India use the private sector for outpatient care curative services, albeit a slight decline is noted between 1995–96 and 2004. The utilization of private sector for outpatient services has become more inequitable across expenditure quintiles, favouring the rich at the national level during the period 1995–96 to 2004. There are also large inter-state variations in the choice between private and public provision for poor and non-poor people at the state level. The results indicate that Himachal Pradesh is the only state where the public outpatient services are well targeted and fairly accessible to the poor people (84 per cent) than other states. The multivariate analysis suggests that the gap in access to private provider for outpatient care between poor and non-poor, highly educated and uneducated and scheduled tribes (STs) and other social groups have broadened over the study period. Unlike outpatient care, the results show a trend of declining use of public health facilities for inpatient care. A sizeable proportion of the poor were forced to visit private provider due to non-availability of public facilities: this suggests the need for the public health care system to be responsive to the needs of the poor by ensuring availability of quality services in the public facilities.