Background: The rising burden of the elderly represents an increasing burden for a public health challenge. Elderly individuals play an important role in choosing healthcare utilization. Unfortunately, the elderly are facing high out-of-pocket expenditures (OOPE). Henceforth, it is important to understand the nature of inefficiencies that exist among individuals. Methods: Data was from the National Sample Survey Organization (NSSO) report titled ‘Social Consumption in India: Health’ from the 75th round, which was collected between July 2017 and June 2018. The Stochastic Frontier Analysis (SFA) was used to estimate individual efficiency. OOPE was used as output, while annual per capita consumer expenditure was taken as input, and Andersen’s Behavioural health determinants were covariates. Results: A total of 12,566 elderly inpatients show OOPE may increase by 18 per cent with an increase in annual per capita consumer expenditure. The mean efficiency score across the individuals was 0.27 (SD:0.003). Also, average efficiency was estimated to be about 0.26 and 0.29 for private and public facilities, respectively. Similarly, higher education, private care, long duration stay, poor self-rated health and immobile elderly inpatients were spending more. However, females were spending less than males. Insurance acts as a protective factor. Overall, the level of technical efficiency (TE) score suggests the need for improvement. Conclusion: Expansion of health insurance coverage may lower the risk of OOPE. Increased funding and support for females may be recommended.