Utilisation of Public Healthcare Facilities

This is in response to an earlier article which claims that there has been a significant increase in the utilisation of public healthcare facilities by the poor and a reduction in out-of-pocket expenses in healthcare. However, this article cautions on methodological issues and the possible errors of interpretation in the earlier article. It also highlights the possibility of a fundamental flaw in either the 71st or 75th survey rounds.

The article “Invest More in Public Healthcare Facilities: What Do NSSO 71st and 75th Rounds Say?” (Muraleedharan V R et al 2020) claims that there has been a significant increase in the utilisation of public healthcare facilities by the poor for outpatient and inpatient care. They then claim that this has led to a reduction in out-of-pocket expenses (OOPE). The article concludes with the assertions for strengthening the public healthcare facilities. This article wholeheartedly agrees with the authors on the need for substantial inve­stment in the public healthcare system. However, this article is in disagreement with some of their selective use and inter­pretation of the data, methods, asser­tions, and conclusions. This article specifi­cally highlights (i) the possibility of a fundamental flaw in either 71st round survey (for 2014) or the 75th round survey (for 2017–18) data set; (ii) the fact that the increase in outpatient and inpatient care in government facilities is not uniform; (iii) that there is no correlation between the shift to government facilities and the fall in OOPE; and lastly (iv) there has not been an increase in government expenditure on healthcare.