Methodological Evaluation of District Hospital Systems in Kenya: A Randomized Field Trial for Cost-Effectiveness Assessment

This study evaluates the operational efficiency of district hospitals in Kenya through a randomized field trial to assess cost-effectiveness. A randomized field trial design was employed to compare the performance metrics of two sets of district hospitals under different operational scenarios. Data collection included cost inputs and outputs over a six-month period. The analysis revealed that by optimising resource utilization, there is potential for reducing hospital costs by up to 20% without compromising on patient care quality. The findings suggest significant room for improvement in district hospital systems through targeted interventions, which could lead to more equitable healthcare access across Kenya. District health authorities are recommended to implement resource management strategies based on the study's results to enhance system efficiency and reduce operational costs. Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.