District hospitals in Rwanda face challenges in resource allocation and operational efficiency. A systematic review of existing studies employing panel data techniques to measure hospital system performance in Rwanda. Panel-data estimation revealed a significant improvement (15%) in operational efficiency across hospitals over five years. The methodological evaluation highlights the importance of consistent and robust panel-data methodologies for assessing hospital systems. Implementing standardised panel-data models can enhance the accuracy and reliability of future studies on hospital performance. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.