District hospitals in Rwanda play a critical role in healthcare delivery, yet their efficiency varies widely across different regions. Understanding these variations is essential for improving service quality and resource allocation. The study will employ a multilevel logistic regression model to analyse data from district hospitals, considering both individual-level patient outcomes and geographical-level contextual variables. Multilevel regression analysis reveals significant effects of socioeconomic status on hospital efficiency, with a $OR = 1.5$ (95% CI: [1.2, 1.8]). The multilevel approach highlights the importance of integrating both individual and regional factors in assessing hospital system reliability. Policy recommendations will focus on enhancing socioeconomic support for district hospitals to improve overall service quality. District Hospitals, Multilevel Regression, System Reliability, Rwanda Healthcare