Background: Healthcare in Ghana is characterised by high expenditures, multiple professions and specialties, complicated processes, and diverse workforces, all of which highlight the importance of evaluating service efficiency through a robust performance appraisal system. Objective of the study: This study aimed to assess the efficiency of four regional hospitals in Ghana in 2020. Method: Secondary data of four regional hospitals on bed occupancy rates, average length of stay and bed turnover rates, among others, were collected from District Health Information Management System (DHIMS) for further analysis. Pabón Lasso charts were drawn using Microsoft Excel 2019 to evaluate the efficiency level of hospitals and wards. Results and conclusion: The study compared the performance of regional hospitals in 2020. The results showed that the Greater Accra and Brong Ahafo were inefficient, the upper East regional hospital was less efficient while the Eastern regional hospital was efficient. It was also found that the medical, maternity and surgical wards of the Brong Ahafo hospital were inefficient. The emergency ward was the most efficient unit in the eastern regional hospital while that of the Upper East region was inefficient. The medical and surgical units of the Greater Accra regional hospital were less efficient.