Government Budgetary Expenditure on Health and Its Impact on Infrastructure, Management, and Economic Growth in Goa State

Abstract

This study provides an empirical evaluation of government budgetary expenditure on healthcare in Goa State and rigorously assesses its structural impact on healthcare infrastructure, clinical service delivery performance, and Gross State Domestic Product (GSDP). Utilizing audit data from the Comptroller and Auditor General (CAG) of India, state financial accounts, and empirical performance metrics spanning FY 2016–17 through FY 2026–27, this paper analyzes fiscal outlays across the Public Health Department (PHD), Directorate of Health Services (DHS), and Goa Medical College and Hospital(GMCH).
While total public health spending expanded substantially from ₹683.97 crore (1.09% of GSDP) in 2016–17 to ₹2,217.00 crore (1.69% of GSDP) in 2026–27, primary healthcare received a sub-optimal average of only 19.94% of total health allocations, severely violating the 66% primary care target established by the National Health Policy (NHP) 2017. Furthermore, capital budget utilization remained highly inefficient, ranging between 26% and 41% annually. Critical structural gaps include a 51% vacancy rate among regular doctors/specialists at the tertiary level and acute physical infrastructure deficits of 24.4% in Sub-Centres, 41.7% in Primary Health Centres, and 50.0% in Community Health Centres relative to Indian Public Health Standards (IPHS).
Calculated macro-fiscal elasticity (E_he = 0.338) and sub-period dynamic elasticity indices demonstrate that while health spending expands faster than economic output during expansionary cycles, operational bottlenecks, procurement delays, and severe patient-bypassing of peripheral facilities moderate the overall macroeconomic multiplier of public health investments in Goa. Key policy recommendations include establishing a centralized drug procurement body, rebalancing fiscal allocations toward primary health, and institutionalizing mandatory prescription quality audits.