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The study aims to evaluate the methodological quality of quasi-experimental studies measuring efficiency in South African district hospitals.

March 13, 2026Open Access

Methodological Evaluation of District Hospital Systems in South Africa: A Meta-Analysis of Quasi-Experimental Designs for Measuring Efficiency Gains

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Meta-analysis evaluates efficiency gains in district hospitals, suggesting improved methods for future studies.

The study aims to evaluate the methodological quality of quasi-experimental studies measuring efficiency in South African district hospitals.
Systematic search for quasi-experimental studies
Appraisal of methodological quality using Cochrane ROBINS-I tool
Quantitative synthesis of efficiency measures using a random-effects meta-regression model
Heterogeneity assessment with I^2 statistic
63% of included studies exhibited serious risk of bias due to confounding
Pooled estimate indicates a mean reduction of 0.8 days in average length of stay
Substantial heterogeneity observed (I^2 = 78%)
Inconsistent methodological reporting limits comparability

Merwe et al. (2021) studied this question.

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