The healthcare landscape in Ethiopia is characterized by a fragmented system of district hospitals, which can lead to inefficiencies and inequities in service delivery. A quasi-experimental design was employed to compare pre- and post-intervention data from randomly selected districts. Key variables included healthcare costs, service utilization rates, and patient satisfaction scores. The analysis revealed that district hospitals with improved management practices saw a 20% increase in resource efficiency (p < 0.05), translating to $1.2 million annually per hospital. The quasi-experimental design provided robust insights into the cost-effectiveness of healthcare system improvements, highlighting potential areas for policy intervention. District hospitals should prioritise training programmes and management reforms to optimise resource utilization and enhance patient care outcomes. Healthcare Systems, District Hospitals, Quasi-Experimental Design, Cost-Effectiveness Analysis, Ethiopia Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.