District hospitals in Ethiopia play a crucial role in healthcare provision, yet their effectiveness varies significantly across regions. A comprehensive literature review was conducted, incorporating data from multiple studies. Quantitative methods were employed for analysis, including a time-series forecasting model (e.g., ARIMA). Uncertainty was quantified through robust standard errors. District hospitals in Addis Ababa showed an average cost-effectiveness ratio of $0.85 per patient treated, with significant variability across regions. The time-series forecasting model provided insights into future trends and potential interventions to enhance system performance. Strategic investments should be prioritised in underserved districts based on the identified cost-effectiveness ratios. district hospitals, cost-effectiveness, Ethiopia, forecasting, healthcare systems Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.