This is a Performance Audit of District Hospital Outcomes in Jharkhand, covering the period 2014-19. This performance audit was carried out during 2019-20 with the objective of assessing the quality of medical services and patient care being provided by District Hospitals (DHs) in the State. In this outcome based audit, we have focused on patient care received at the DHs in the State. Various services like Out-Patient and In-Patient Services, Maternity Services, Diagnostic Services, Infection Control and Drug Management have been assessed on the basis of pre-determined criteria in the sampled DHs. We have also used pre-determined outcome indicators for assessing In-Patient Services. District hospitals being the pivotal point of the public health system in Jharkhand, influence the performance of the entire healthcare system. Despite a considerable increase in public health expenditure in the State during 2014-19, this performance audit revealed that the test-checked district hospitals (DHs) did not fare well on the outcome indicators relating to efficiency, service quality and clinical care capabilities.