District hospitals in Ethiopia face significant operational challenges that impact patient outcomes and healthcare delivery. A mixed-methods approach incorporating quantitative analysis with qualitative insights to assess system performance over time. Panel-data regression models reveal that implementing targeted financial support programmes reduced patient wait times by up to 25% in selected districts. The study underscores the importance of tailored interventions for enhancing hospital efficiency and improving service delivery. District health authorities should prioritise investment in infrastructure and training programmes alongside financial assistance initiatives. district hospitals, Ethiopia, panel data, risk reduction, healthcare systems Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.