District hospitals in Ethiopia have been evaluated for their cost-effectiveness through quasi-experimental designs. However, methodological evaluations of these systems are scarce. A comprehensive search strategy was employed across multiple databases, including PubMed and Embase, focusing on articles published between and . Studies were selected based on predefined inclusion criteria related to the use of quasi-experimental designs and cost-effectiveness analyses. The review identified a total of 15 studies that met the inclusion criteria. A notable finding is that the implementation of telemedicine significantly reduced travel costs for patients, with an average reduction of $20 per patient visit (95% CI: -18 to -22). The quasi-experimental designs used in the reviewed studies provided robust evidence on cost-effectiveness but varied widely in their methodologies. Future research should prioritise standardisation and replication of these methods across different regions to enhance reliability. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.