Methodological Evaluation of District Hospitals Systems in Ethiopia Using Quasi-Experimental Design for Cost-Effectiveness Studies

District hospitals in Ethiopia play a critical role in delivering healthcare services, but their operational efficiency varies widely. A systematic literature review will be conducted using a quasi-experimental design. Studies published in English between and will be included, focusing on Ethiopia's context. The analysis revealed that the majority of studies used regression models to estimate cost-effectiveness, with some employing multivariate analyses for robustness checks (e. g. , Y = a + bX + cZ). There was variability in sample sizes and control variables considered. This review highlights gaps in methodological rigor, particularly concerning the handling of confounding factors and the generalizability of findings across different regions. Future studies should prioritise transparent reporting of methods and data sources to enhance replicability and comparability. district hospitals, cost-effectiveness, Ethiopia, quasi-experimental design, regression analysis