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Syrian Refugees Crisis Impact on Lebanese Public Hospitals- Financial Impact Analysis: APIS Report


The impact of the Syrian crisis on Lebanon has been profound particularly in the healthcare sector. The influx of Syrian refugees has strained the public hospitals and their ability to respond to the crisis, resulting in:
  • An increased demand for healthcare services;
  • An increase in unpaid health services to refugees;
  • A sharp rise in communicable diseases and emergence of new diseases in Lebanon;
  • Increased risks of epidemics such as water-borne diseases, measles, and tuberculosis 1.
Neither United Nations High Commissioner of Refugees (UNHCR) nor other Non-Governmental Organizations (NGO) was able to meet the required level of funding to provide refugees with an acceptable level of secondary and tertiary healthcare services. They, therefore, decided to change their model of response in terms of healthcare support to Syrian refugees. As of 2014, UNHCR started covering 75% instead 85% of the hospitalization cost, leaving the patient with the remaining share of 25% to be paid out of pocket or by a third party. The healthcare referrals covered by UNHCR are limited to deliveries and life-threatening emergencies 2.

Hospitals are overburdened with Syrian patients who are unable to pay their part of the bill (increased to 25% of their total hospital fees) as well as patients whose hospitalizations are not subsidized at all. Some hospitals have put in place strategies to recover as much of the 25% as possible (deposits, retaining IDs/corpses, inflating bills). Referral of uncovered Syrian patients with complicated morbidities to public hospitals has become a common practice by private hospitals.

Overwhelmed by the high demand of healthcare by Syrian refugees, public hospitals end up treating patients without any specific reimbursement scheme thus creating a huge financial burden. This burden adds up to the existing difficult financial situation of public hospitals, putting the whole healthcare sector under stress. Public hospitals are restrained from completing their mission and incapable of providing healthcare services neither to Syrians refugees nor to Lebanese citizens...
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ATC Name B/G Ingredients Dosage Form Price
R06AX26 EXOFEN G Fexofenadine HCl - 120mg 120mg Tablet, film coated 287,582 L.L
L01EA02 DASATINIB NEAPOLIS G Dasatinib - 70mg 70mg Tablet, film coated L.L
C07BB12 NEBILET PLUS B Nebivolol HCl - 5mg, Hydrochlorothiazide - 25mg Tablet, film coated 716,268 L.L
C09DB02 OLMENOR COMBI G Olmesartan medoxomil - 40mg, Amlodipine - 5mg Tablet, film coated 772,709 L.L
M01AH05 ARCOXIA B Etoricoxib - 60mg 60mg Tablet, film coated 993,100 L.L
N03AX23 BRIVIACT B Brivaracetam - 50mg 50mg Tablet, film coated 9,627,931 L.L
N06AB10 CIPRALEX B Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 2,378,601 L.L
R06AX26 FENADEX 120 G Fexofenadine HCl - 120mg 120mg Tablet, film coated 295,645 L.L
L01EA02 DASATINIB NEAPOLIS G Dasatinib - 50mg 50mg Tablet, film coated L.L
A04AA01 NOZENTRIX G Ondansetron - 8mg 8mg Tablet, film coated 1,151,865 L.L
C09DB02 SEVIKAR B Olmesartan medoxomil - 40mg, Amlodipine - 10mg Tablet, film coated 1,245,742 L.L
M01AH05 ARTRIX 60 G Etoricoxib - 60mg 60mg Tablet, film coated 904,854 L.L
N06AB10 CITOXAL G Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 2,166,786 L.L
R06AX26 EXOFEN G Fexofenadine HCl - 180mg 180mg Tablet, film coated 287,582 L.L
A04AA01 ONDAKEY G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, film coated 4,489,778 L.L
C07FB07 CONCOR AM 2.5 B Bisoprolol fumarate - 2.5mg, Amlodipine besylate - 5mg Tablet, film coated 1,377,012 L.L
C09DB02 VOCADO B Olmesartan medoxomil - 40mg, Amlodipine besylate - 10mg Tablet, film coated 1,186,613 L.L
M01AH05 CONSORT G Etoricoxib - 60mg 60mg Tablet, film coated 212,327 L.L
R06AX26 FENADEX 180 G Fexofenadine HCl - 180mg 180mg Tablet, film coated 295,645 L.L
C07FB07 CONCOR AM 5 B Bisoprolol fumarate - 5mg, Amlodipine besylate - 5mg Tablet, film coated 1,377,012 L.L
M01AH05 COXIFLAM G Etoricoxib - 60mg 60mg Tablet, film coated 904,854 L.L
N06AB10 PRAMACYT 15 G Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 921,492 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
A04AA01 ONDANSETRON MEDIS G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, film coated 748,520 L.L
A10BD02 GLUCOVANCE B Metformin HCl - 500mg, Glibenclamide - 2.5mg Tablet, film coated 563,663 L.L
M01AH05 ETOXA G Etoricoxib - 60mg 60mg Tablet, film coated 904,854 L.L
N06AB10 PRYLEX 15 G Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 921,492 L.L
R06AX27 AERIUS B Desloratadine - 5mg 5mg Tablet, film coated 430,030 L.L
G03AA12 YASMIN B Drospirenone - 3mg, Ethinylestradiol - 30mcg Tablet, film coated 616,824 L.L
M01AH05 ETOXA G Etoricoxib - 60mg 60mg Tablet, film coated 302,045 L.L
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