This study evaluates the systems of district hospitals in Rwanda to identify areas for improvement. Multilevel regression analysis was employed to evaluate data from district hospitals across Rwanda. Data indicated a need for enhanced coordination between primary care facilities and regional hospitals (β = -0.75, p < 0.01). District hospital systems require better integration to achieve higher yield in healthcare delivery. Implementing inter-hospital communication protocols is recommended to address identified issues. district hospitals, Rwanda, multilevel regression analysis, yield improvement Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.