Methodological Evaluation of District Hospitals Systems in Rwanda: Panel Data Estimation for System Reliability Measurement

Rwanda's district hospitals play a critical role in its health system, but their performance varies significantly across regions and over time. Panel data analysis was employed to assess system reliability. The study utilised a mixed-effects model with robust standard errors to account for temporal and spatial dependencies within the dataset. Analysis revealed that hospital bed availability (20-35% of capacity) significantly impacts patient wait times, suggesting underutilization as a critical issue in maintaining optimal service delivery reliability. The identified factors contribute to system inefficiencies, indicating the need for targeted interventions and resource allocation strategies within Rwanda’s district hospitals. Implementing data-driven management practices and improving bed utilization could enhance overall system reliability and patient care quality. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.