District hospitals in Nigeria face challenges in maintaining consistent clinical outcomes due to varying system efficiencies. A time-series analysis was employed using cross-sectional survey data from 10 districts over three years. Panel data regression models were applied to assess the impact of various factors on patient outcomes. The estimated model revealed a significant positive relationship between investment in infrastructure and clinical performance, with an R² value of 0.75 indicating substantial explanatory power. District hospital systems in Nigeria can be improved by targeted investments in infrastructure to enhance clinical outcomes. Investment priorities should focus on upgrading healthcare facilities, training staff, and implementing standardised protocols to improve patient care. district hospitals, panel data, clinical outcomes, investment impact Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.