Healthcare Disparities in India: A Comprehensive QualitativeAnalysis

Authors

  • Somenath Chatterjee Research Scholar, EPHD ,Indian Institute of Management, Ranchi Author

DOI:

https://doi.org/10.66635/5rzcam55

Keywords:

Healthcare disparities, Healthcare access, Out-of-pocket expenditure, Health insurance, Public-private healthcare

Abstract

India's healthcare system is still highly stratified, with underprivileged groups being disproportionately affected by differences in access, cost, and quality of care. Healthcare outcomes are still shaped by socioeconomic, geographic and systemic factors, which result in notable disparities in service consumption. Although financial protection mechanisms and legislative initiatives have attempted to address these issues, their efficacy has been constrained by gaps in healthcare financing, inconsistent implementation, and ineffective governance. This study uses a thorough examination of data on healthcare accessibility, inefficiencies in the public and private sectors, and financial burden to critically explore the structural impediments that lead to these inequities. The study emphasizes how urgently fundamental changes are required, such as more investment in public health infrastructure, more regulatory monitoring of commercial healthcare providers, and strategic budgetary policies. Opportunities to overcome healthcare gaps are presented by technological innovations like telemedicine and AI-driven diagnostics, but infrastructure limitations and digital literacy still limit their accessibility. This study adds to the continuing conversation about building a more resilient and equitable healthcare system in India by pointing out important policy gaps and proposing remedies. All-around reforms with emphasis in equity, efficiency, and financial protection would emphasize India's complete bridging of the healthcare gap. A combination of both public and private strengths, adapted to the needs of the underserved populations, is critical toward putting together a robust and inclusive healthcare system.

 

References

1.Ahmed, S., & Mahapatro, S. (2023). Inequality in Healthcare Access at the Intersection of Caste and Gender. Contemporary Voice of Dalit, 15(1_suppl), S75–S85. https://doi.org/10.1177/2455328X221142692

2.Chitnis, A., & Mishra, D. K. (2019). Performance Efficiency of Indian Private Hospitals Using Data Envelopment Analysis and Super-efficiency DEA. Journal of Health Management, 21(2), 279–293. https://doi.org/10.1177/0972063419835120

3.Sahoo, P. M., Rout, H. S., & Jakovljevic, M. (2023). Consequences of India’s population aging to its healthcare financing and provision. Journal of Medical Economics, 26(1), 308–315. https://doi.org/10.1080/13696998.2023.2178164

4.Das, T., & Guha, P. (2023a). Pattern of Public Healthcare Expenditure and Preparedness for COVID-19 in India: An Interstate Analysis. Journal of Health Management, 25(4), 903–917. https://doi.org/10.1177/09720634231215390

5.Datta, P., & Chaudhuri, C. (2022). Is Profit Motive Infecting Indian Private Health Care Sector? Journal of Health Management, 24(2), 222–232. https://doi.org/10.1177/09720634221088064

6.Doyle, J. J., Hawryluk, E., Niemira, J., & Wood, B. (2019). Evidence-Based Valuation in Oncology: Lessons Learned from a Case Study. Therapeutic Innovation & Regulatory Science, 53(3), 403–411.

7.Dubey, J. D. (2024). Income Elasticity of Demand for Healthcare and Change Over Time: Across the Income Groups in India. Journal of Health Management. https://doi.org/10.1177/09720634241263392

8.Debata, B. R., Sree, K., Patnaik, B., & Mahapatra, S. S. (2013). Benchmarking healthcare tourism enablers in India using ISM. Benchmarking: An International Journal, 20(6), 716–743. https://doi.org/10.1108/BIJ-10-2011-0079

9.Self, S., & Basuroy, S. (2017). Factors influencing healthcare choices by the elderly in India: role of social interactions. International Journal of Social Economics, 44(9), 1231–1251. https://doi.org/10.1108/IJSE-12-2015-0340

10.Gaddam, R., & Rao, K. R. (2023). Incidence, Inequality and Determinants of Catastrophic Health Expenditure in India. Journal of Health Management, 25(1), 30–39. https://doi.org/10.1177/09720634231153226

11.Gopalan, S. S., Das, A., & Mutasa, R. (2014). What makes Health Demand-Side Financing Schemes Work in Low- and Middle-Income Countries? A Realist Review. Journal of Public Health Research, 3(3), 304. https://doi.org/10.4081/jphr.2014.304

12.Sodhi, C., & Singh, P. (2016). Health service system in transition: influence of British and US healthcare systems on India. International Journal of Health Governance, 21(4), 204–221. https://doi.org/10.1108/IJHG-03-2016-0020

13.Forbes, D. J. (2012). Healthcare provision in rural India: does micro health insurance help or hinder? International Journal of Health Care Quality Assurance, 25(3), 216–225. https://doi.org/10.1108/09526861211210439

14.Esposito, M., Kapoor, A., & Goyal, S. (2012). Enabling healthcare services for rural and semi-urban segments in India. Corporate Governance, 12. https://doi.org/10.1108/14720701211267847

15.Hooda, S. K. (2017). Out-of-pocket Payments for Healthcare in India: Who Have Affected the Most and Why? Journal of Health Management, 19(1), 1–15.

16.Ghia, C., & Rambhad, G. (2023). Implementation of equity and access in Indian healthcare: current scenario and way forward. Journal of Market Access & Health Policy, 11(1). https://doi.org/10.1080/20016689.2023.2194507

17.Chakraborty, R., & Chakraborti, C. (2015). India, Health Inequities, and a Fair Healthcare Provision: A Perspective from Health Capability. Journal of Human Development and Capabilities, 16(4), 567–580. https://doi.org/10.1080/19452829.2015.1105201

18.Rautela, S., Panackal, N., & Sharma, A. (2024). Integrated healthcare system in India: a conceptual framework. Journal of Integrated Care, 32(3), 285–302. https://doi.org/10.1108/JICA-01-2024-0002

19.Yadav, A. K., & Jena, P. K. (2022). Explaining changing patterns and inequalities in maternal healthcare services utilization in India. Journal of Public Affairs, 22, e2570. https://doi.org/10.1002/pa.2570

20.Kumar, R., & Duggirala, A. (2021). Health Insurance as a Healthcare Financing Mechanism in India. Vikalpa, 46(2), 112–128. https://doi.org/10.1177/02560909211027089

21.Tiwari, R. (2022). Nexus between intellectual capital and profitability with interaction effects: Indian healthcare industry. Journal of Intellectual Capital, 23(3), 588–616. https://doi.org/10.1108/JIC-05-2020-0137

22.Panda, A., & Mohapatra, S. (2021). Online Healthcare Practices and Associated Stakeholders. Vikalpa, 46(2), 71–85. https://doi.org/10.1177/02560909211025361

23.Akintoye, A., & Chinyio, E. (2005). Private Finance Initiative in the healthcare sector: trends and risk assessment. Engineering, Construction and Architectural Management, 12(6), 601–616. https://doi.org/10.1108/09699980510634155

24.Gholipour, H. F., & Esfandiar, K. (2025). Does medical tourism promote growth in healthcare sector? European Journal of Health Economics, 26, 233–241. https://doi.org/10.1007/s10198-024-01700-3

25.Vishnu, C. R., Anilkumar, E. N., Sridharan, R., et al. (2023). Statistical characterization of managerial risk factors: state-run hospitals in India. OPSEARCH, 60, 812–834. https://doi.org/10.1007/s12597-023-00633-4

26.Bhatia, M., Dwivedi, L. K., Banerjee, K., et al. (2021). Pro-poor policies and improvements in maternal health outcomes in India. BMC Pregnancy and Childbirth, 21, 389. https://doi.org/10.1186/s12884-021-03839-w

27.Rahman, T., Gasbarro, D., & Alam, K. (2022). Financial risk protection against noncommunicable diseases: trends in Bangladesh. BMC Public Health, 22, 1835. https://doi.org/10.1186/s12889-022-14243-0

28.Manna, S., Singh, D., Ghosal, S., et al. (2023). Out-of-pocket expenditure for institutional deliveries in India: findings from NFHS-5. BMC Public Health, 23, 1474. https://doi.org/10.1186/s12889-023-16352-w

29.Feng, Z., Chen, Q., Jiao, L., et al. (2024). The impact of health insurance on hypertension care in India. BMC Public Health, 24, 2287. https://doi.org/10.1186/s12889-024-19759-1

30.Malik, E., & Shankar, S. (2023). Empowering nurses: self-managed organizations in Indian healthcare. BMC Nursing, 22, 477. https://doi.org/10.1186/s12912-023-01647-5

31.Kazibwe, J., Tran, P. B., Kaiser, A. H., et al. (2024). The impact of health insurance on maternal and reproductive health service utilization in LMICs: a systematic review. BMC Health Services Research, 24, 432. https://doi.org/10.1186/s12913-024-10815-5

32.Surendran, S., Joseph, J., Sankar, H., et al. (2024). Exploring the road to public healthcare accessibility in Kerala, India. International Journal for Equity in Health, 23, 157. https://doi.org/10.1186/s12939-024-02191-7

33.Mohanty, S. K., Wadasadawala, T., Sen, S., et al. (2024). Catastrophic health expenditure and distress financing of breast cancer treatment in India. International Journal for Equity in Health, 23, 145. https://doi.org/10.1186/s12939-024-02215-2

34.Garg, S., Tripathi, N., & Bebarta, K. (2023). Does government health insurance protect households from OOP expenditure for institutional deliveries in India? BMC Research Notes, 16. https://doi.org/10.1186/s13104-023-06335-w

35.Garg, S., Tripathi, N., Ranjan, A., et al. (2022a). How much do government and households spend on hospitalisation in India? Health Economics Review, 12, 27. https://doi.org/10.1186/s13561-022-00372-0

36.Garg, S., Bebarta, K. K., & Tripathi, N. (2022b). Household expenditure on non-Covid hospitalisation during the pandemic in India. Archives of Public Health, 80, 108. https://doi.org/10.1186/s13690-022-00857-8

37.Sengupta, M., Ganguly, A., Roy, A., Chakrabarti, S., & Mukhopadhyay, I. (2024). Conflict Dynamics in Indian Healthcare: Primers of Conflict in Private Clinical Establishments of Kolkata. Journal of Health Management, 26(3), 460–471.

38.Thakur, R., & Sangar, S. (2020). Socioeconomic differentials in the burden of paying for healthcare in India. Health Systems, 11(1), 48–58. https://doi.org/10.1080/20476965.2020.1848356

39.Nyland, K., & Pettersen, I. (2015). Hybrid controls and accountabilities in public sector management: hospital sector case studies. International Journal of Public Sector Management, 28, 90–104. https://doi.org/10.1108/IJPSM-07-2014-0085

40.Sutterer, P., Kolisch, R., & Uzsoy, R. (2022). Valuation of hospital resources: an optimization approach using clearing functions. IISE Transactions on Healthcare Systems Engineering, 12(4), 245–262. https://doi.org/10.1080/24725579.2022.2055236

41.Yadav, P., & Ray, A. S. (2022). Private Sector Presence in Healthcare in India: Econometric Analysis. South Asia Economic Journal, 23(2), 171–200. https://doi.org/10.1177/13915614221113406

42.Malik, M. A., Singh, S. P., & Pattanaik, F. (2022). Economics of Healthy Aging in India: A Multidimensional Perspective. IZA Journal of Labor Policy, 12(4). https://doi.org/10.2478/izajolp-2022-0004

43.Akhtar, A., & Chowdhury, I. R. (2023). Socioeconomic inequity in healthcare utilization among individuals with cardiovascular diseases in India. Health Economics, 32(5), 1000–1018. https://doi.org/10.1002/hec.4651

44.Das, D. (2017). Public expenditure and healthcare utilization: reproductive health care in India. International Journal of Health Economics and Management, 17, 473–494. https://doi.org/10.1007/s10754-017-9219-7

45.Harikrishnan, K., & Hiremath, G. (2024). Inequality in Public Provision of Healthcare: Do Fiscal Transfers Matter? Journal of Public Affairs, 24, e2943. https://doi.org/10.1002/pa.2943

46.Kumar, P. (2022). Market-focused flexibility and innovative performance in public healthcare: Evidence from India. Journal of Public Affairs, 22(S1), e2809. https://doi.org/10.1002/pa.2809

47.Das, T., & Guha, P. (2023b). The puzzle of public health expenditure and healthcare infrastructure in India: An empirical investigation. Regional Science Policy & Practice, 1–37. https://doi.org/10.1111/rsp3.12710

48.Majumder, S., Roy, S., Bose, A., & Chowdhury, I. R. (2023). Understanding regional disparities in healthcare quality and accessibility in West Bengal, India. Regional Science Policy & Practice, 15(5), 1086–1113. https://doi.org/10.1111/rsp3.12607

49.Hunter, B., & Murray, S. F. (2019). Deconstructing the financialization of healthcare. Development and Change, 50(5), 1263–1287. https://doi.org/10.1111/dech.12517

50.Duran, A., et al. (2015). Public Hospital Governance in India. In D. Huntington & K. Hort (Eds.), Public Hospital Governance in Asia and the Pacific (pp. 222–255). World Health Organization. http://www.jstor.org/stable/resrep28456.9

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Published

2026-09-03

How to Cite

Healthcare Disparities in India: A Comprehensive QualitativeAnalysis. (2026). Journal of Asia Entrepreneurship and Sustainability, 22(5s), 511-520. https://doi.org/10.66635/5rzcam55