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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
C08CA01 AMLOR B Amlodipine besylate - 5mg 5mg Capsule 560,382 L.L
N06DA02 ARICEPT B Donepezil HCl - 5mg 5mg Tablet, film coated 3,254,787 L.L
S01EA05 ALPHAGAN P B Brimonidine tartrate - 0.1% 0.15% Drops solution 999,819 L.L
A10BB12 AMARYL B Glimepiride - 3mg 3mg Tablet 392,402 L.L
S01EC04 AZOPT B Brinzolamide - 10mg/ml 10mg/ml Drops suspension 804,962 L.L
N06DA02 ARICEPT B Donepezil HCl - 10mg 10mg Tablet, film coated 3,776,197 L.L
A10BB12 AMARYL B Glimepiride - 4mg 4mg Tablet 392,402 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 3mg 3mg Capsule, prolonged release 68,645,618 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 1mg 1mg Capsule, prolonged release 25,729,044 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 5mg 5mg Capsule, prolonged release 85,485,667 L.L
L04AD02 ADVAGRAF B Tacrolimus monohydrate - 0.5mg 0.5mg Capsule, prolonged release 13,297,758 L.L
A10BD05 ACTOSMET B Metformin - 850mg, Pioglitazone - 15mg Tablet, film coated 3,101,588 L.L
M04AA03 ADENURIC B Febuxostat - 120mg 120mg Tablet, film coated 2,184,704 L.L
S01GX07 ALLERGODIL B Azelastine HCl - 0.5mg/ml 0.5mg/ml Drops solution 709,549 L.L
B01AC06 ASPIRIN PROTECT B Acetylsalicylic acid - 100mg 100mg Tablet, enteric coated 146,479 L.L
M04AA03 ADENURIC B Febuxostat - 80mg 80mg Tablet, film-scored 2,127,111 L.L
B01AC17 AGGRASTAT B Tirofiban hydrochloride monohydrate - 0.25mg/ml 0.25mg/ml Injectable concentrated solution 18,280,324 L.L
S01HA02 ANESTOCIL B Oxybuprocaine HCl (Benoxinate HCl) - 0.4% 0.4% Drops solution 442,124 L.L
M04AA03 ADENURIC B Febuxostat - 40mg 40mg Tablet, film coated 1,687,866 L.L
N02BG06 ACUPAN B Nefopam HCl - 20mg 20mg Injectable solution 365,525 L.L
A04AA05 ALOXI B Palonosetron HCl - 0.25mg/5ml 0.25mg/5ml Injectable solution 3,656,595 L.L
A04AA55 AKYNZEO B Palonosetron - 0.5mg, Netupitant - 300mg Capsule, hard 7,364,372 L.L
D06BB10 ALDARA B Imiquimod - 5% 5% Cream 6,301,277 L.L
L01XK52 AKEEGA B Niraparib - 100mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
L01XK52 AKEEGA B Niraparib - 50mg, Abiraterone acetate - 500mg Tablet, film coated 519,366,124 L.L
N05AX12 ABILIFY MAINTENA B Aripiprazole - 400mg 400mg Injectable powder for suspension, prolonged release+solvent 29,491,998 L.L
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