Maharashtra records lowest public hospital utilisation rate among all states

Only about one-fifth of patients in Maharashtra seek care in public hospitals, according to the latest National Statistical Office (NSO) 80th round survey on household health expenditure. This marks the lowest public hospital utilisation rate among all Indian states.

Despite being one of India’s more affluent states and having over 30 government medical and dental colleges, Maharashtra shows a stark imbalance between public and private healthcare usage. The data reveals that 77% of hospitalisations occur in the private sector, while only 18.6% take place in public hospitals.

Dr Abhay Shukla of Jan Swasthya Abhiyan (JSA) highlighted that this figure reflects a systemic issue, pointing to what he described as a failed policy of healthcare privatisation.

Comparison with other states
In contrast, several other states demonstrate significantly higher reliance on public healthcare. Tamil Nadu reports 43% public hospitalisations, Rajasthan 45.3%, West Bengal 58.8%, and Goa leads with 64.7%. Notably, the national average stands at 36.7%, making Maharashtra’s figures particularly concerning.

Rising cost of private healthcare
At the same time, Maharashtra continues to experience steep health inflation and rising out-of-pocket expenses. According to the NSO data, the average cost of private hospitalisation in rural areas has reached ₹44,580, while urban costs stand at ₹67,831.

When compared to the 2017–18 survey, these figures show a sharp increase. Rural hospitalisation costs have risen from ₹23,821, marking an 87% jump, while urban costs have increased from ₹42,540.

Although cumulative inflation between 2018 and 2025 stands at approximately 43%, private healthcare costs have nearly doubled that rate. This trend suggests significant price escalation, which experts attribute to limited regulation and profit-driven practices in the private sector.

Persistent out-of-pocket expenses in public healthcare
Even within public hospitals, patients continue to bear notable expenses. Rural public hospitalisation now costs an average of ₹8,080, up from ₹5,606 in 2018. Similarly, urban public hospitalisation expenses have increased to ₹8,364 from ₹7,189.

A major portion of these expenses arises from the private purchase of medicines and diagnostic tests, despite the expectation that such services should be provided free of cost in government facilities.

Limited impact of government insurance schemes
Furthermore, government-backed health insurance schemes such as the Pradhan Mantri Jan Arogya Yojana (PMJAY) and the Mahatma Phule Jan Arogya Yojana (MJPJAY) appear to offer limited financial protection in practice.

Although these schemes promise coverage of up to ₹5 lakh per hospitalisation, the NSO data tells a different story. The average total hospitalisation cost in Maharashtra stands at ₹44,778, out of which ₹40,495 is still paid directly by patients. In effect, nearly 90% of healthcare expenses continue to come from individuals’ pockets.

Call for strengthening public healthcare
Experts argue that these findings highlight the urgent need for policy reform. Despite the lessons from the Covid-19 pandemic—during which Maharashtra recorded the highest number of deaths in the country—public healthcare investment remains inadequate.

Dr Shukla emphasised that the state must prioritise expanding public health infrastructure. At the same time, authorities should implement stricter regulations to control pricing in the private healthcare sector. The Indian Practitioner