District hospitals in Senegal play a critical role in healthcare delivery, yet their effectiveness and cost-effectiveness are poorly understood. A randomized field trial was conducted across selected districts to measure the efficiency of district hospitals. Data on patient outcomes, resource utilization, and costs were collected using standardised tools. The study revealed that implementing telemedicine services reduced inpatient stays by 15% with a cost-saving effectivity ratio of $2:1 per case treated. This randomized field trial provides evidence on the effectiveness of district hospital systems and highlights the potential benefits of integrating digital health solutions. District hospitals should consider adopting telemedicine to optimise resource allocation, enhance patient outcomes, and reduce costs. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.