Cost-Effectiveness Evaluation of District Hospital Systems in Uganda: A Randomized Field Trial

District hospitals in Uganda face significant challenges in providing cost-effective healthcare services to their populations. A randomized controlled trial was conducted across five districts, employing mixed methods including surveys, clinical audits, and economic modelling to assess service delivery efficiency and patient outcomes. The analysis revealed that the average cost per patient consultation decreased by 10% after implementing evidence-based interventions, with a 95% confidence interval for this reduction ranging from -2.5 to -7.5% This study provides robust evidence on the potential of randomized trials in evaluating district hospital systems and highlights specific areas where resources can be more efficiently allocated. District health authorities should prioritise training programmes for healthcare providers, focusing on best practices from successful interventions identified through this trial. district hospitals, cost-effectiveness, randomized field trial, Uganda Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.