ORIGINAL RESEARCH article
Front. Public Health
Sec. Public Health Policy
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1491297
This article is part of the Research TopicPublic Health Outcomes: The Role of Social Security Systems in Improving Residents' Health WelfareView all 33 articles
Multivariate Decomposition of Shift Towards Public Facilities for Inpatient Care in Rural India: Evidence from National Sample Survey
Provisionally accepted
- National Health Systems Resource Center, New Delhi, India
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Introduction: Public facilities in health systems are essential for improving access and ensuring equity. Public facility utilization for inpatient care in rural areas increased between the most recent National Sample Survey (NSS) health rounds of 2014 and 2017-18. This study conducted a decomposition analysis to identify the underlying causes that contributed to this increase in public facility utilization.The study used the latest available unit-level data from the 2014 and 2017-18 NSS Health Survey. The study employed multivariate decomposition analysis based on the existing behavioral model of access to health facilities.The public facility utilization for inpatient care in rural areas increased from 41.6% to 45.3% between 2014 and 2017-18. The results of the multivariate decomposition analysis indicate that differences in coefficients account for 81% of the increase in the utilization of public health facilities. Within the coefficients, this increase is mainly driven by the increase in the utilization of public facilities amongst those residing in states with relatively better public health systems (54.3%) and amongst the richest consumption class (45.4%).The utilization of public facilities for inpatient care increased between 2014 and 2017-18 in rural India. This increase in utilization, though, was mostly driven by increased utilization amongst people residing in states with relatively better public health systems and by those belonging to the richer consumption classes. The study indicates that improved public health systems can play an important role in increasing footfall in public health facilities.
Keywords: utilization, Public Facilities, decomposition, Inpatient care, rural India
Received: 04 Sep 2024; Accepted: 14 Apr 2025.
Copyright: © 2025 Sharma, Kumar and Kotwal. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: E Lokesh Kumar, National Health Systems Resource Center, New Delhi, India
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