Methodological Evaluation of District Hospitals' Efficiency Gains in Rwanda: A Quasi-Experimental Study

Efficient healthcare delivery in Rwanda's district hospitals is critical for equitable access to medical services. However, the current efficiency metrics are under scrutiny due to inconsistencies and gaps. The study employed data envelopment analysis (DEA) with robust standard errors to assess hospital performance. Data were collected from to across all districts in Rwanda. District hospitals showed a moderate increase in operational efficiency, with an average improvement of 8% in resource utilization compared to the baseline year (p < 0.05). The quasi-experimental design provided robust insights into hospital performance and highlighted specific areas needing intervention. District hospitals should focus on enhancing service quality, reducing waste, and improving patient flow management strategies. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.