District hospitals in South Africa face challenges in risk reduction due to limited resources and inadequate training for healthcare providers. A systematic review was conducted using databases such as PubMed and Scopus. Studies were selected based on inclusion criteria related to district hospitals' operations and impact of interventions on health outcomes. The analysis revealed that while the difference-in-differences model showed promise in identifying effective risk reduction strategies, its application often faced challenges due to data quality issues and lack of standardised reporting across studies. Despite these limitations, the difference-in-differences model remains a valuable tool for assessing risk reduction efforts in district hospitals, particularly when combined with other evaluation methods. Future research should focus on improving data collection standards to enhance the reliability and validity of results from the difference-in-differences analysis. district hospitals, South Africa, difference-in-differences model, health outcomes, risk reduction Treatment effect was estimated with logit (pᵢ) =₀+^ Xᵢ, and uncertainty reported using confidence-interval based inference.
Khumalo et al. (Wed,) studied this question.