Towards an integrated, inclusive, and accessible healthcare ecosystem

Delhi, India’s capital and one of its most populous urban centres, is home to a diverse and dynamic healthcare ecosystem. The city-state’s healthcare infrastructure is both vast and complex; however, it faces constraints with over 20 million residents and a steady influx of domestic medical tourists.

The Delhi Government supports flagship programmes like Ayushman Bharat Delhi, expansion of Ayushman Arogya Mandirs, and investments in digital health platforms and critical care infrastructure.

The city boasts over 100 government hospitals, several super-specialty institutions, and a thriving private healthcare sector. Yet, the demand for services continues to outpace supply, especially in underserved areas.

Risks of an ageing population, rising NCDs and medical tourism influx

Delhi’s healthcare system faces increasing pressure from three converging trends:

• Ageing population: With increasing life expectancy, Delhi’s elderly population is growing rapidly, leading to a surge in age-related illnesses and chronic conditions.
• Rising incidence of non-communicable diseases (NCDs): Like the rest of India, Delhi is witnessing a sharp rise in NCDs such as diabetes, hypertension, cardiovascular diseases, and cancer. These diseases now account for more than 60% of deaths nationwide and are a significant burden on urban healthcare systems.
• Domestic medical tourism: Delhi attracts patients primarily from neighbouring states of Bihar, Haryana and Uttar Pradesh due to its advanced medical facilities. This influx creates pressure on the healthcare infrastructure designed primarily for Delhi's original population base.

Developed health infrastructure, but low scope for growth

Delhi’s healthcare infrastructure is a complex mosaic of public and private providers, traditional and modern systems, tertiary institutions and grassroots clinics. Among the city hospitals, it can be observed that:

• While private hospitals dominate in terms of sheer numbers, comprising 91% of all facilities, the public sector holds a strategic advantage in capacity, accounting for 51% of total hospital beds. 
• This asymmetry is further accentuated by the nature of care delivered: nearly 70% of public hospital beds are allocated for tertiary care, reflecting the government's role in managing complex and high-acuity cases. 
• Conversely, 70% of private hospital beds are geared towards primary and secondary care, indicating a market orientation towards outpatient and short-stay services. 
• This development underscores the pivotal role of nursing homes and small hospitals as the first point of contact for the neighbourhood, serving as the frontline of care for many residents.
• Medical colleges and teaching hospitals in Delhi also serve as vital hubs for advanced care, emergency services, and specialised treatments, supporting residents and patients from across India and abroad. They are central to the city’s healthcare delivery and medical education system.

Hospital infrastructure expansion in Delhi is constrained by land scarcity, fragmented ownership, and regulatory hurdles. These constraints have shifted investment to NCR regions like Greater Noida and Faridabad, which reflect a strategic geographic rebalancing of healthcare development.