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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
C07BB07 CONCOR PLUS B Bisoprolol fumarate - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,249,926 L.L
C07AB07 CONCOR B Bisoprolol fumarate - 10mg 10mg Tablet, film coated 1,176,665 L.L
C07AB07 CARDIOSAFE 10 G Bisoprolol fumarate - 10mg 10mg Tablet, coated 610,104 L.L
L02BB03 CASODEX B Bicalutamide - 50mg 50mg Tablet, film coated 3,777,541 L.L
L02BB03 CASODEX B Bicalutamide - 150mg 150mg Tablet, film coated 10,863,782 L.L
R02A CHLORASEPTIC TOTAL SORE THROAT + COUGH LOZENGES WILD CHERRY G Benzocaine - 6mg, Dextromethorphan - 5mg, Menthol - 10mg Lozenge 537,537 L.L
R03BA01 CLENIL 250 MCG SPRAY B Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 1,166,455 L.L
R03BA01 CORTIS G Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 674,609 L.L
A11AA COMPLEVIT G Ascorbic acid - 1.32g, Riboflavine - 0.018g, Nicotinamide - 0.264g, Cyanocobalamine - 0.9g, Pyridoxine HCl - 0.132g, Thiamine mononitrate - 0.288g, Iron Ammonium Citrate - 3.6g Syrup 218,854 L.L
R03DA55 CAMPHO-PNEUMINE AMINOPHYLLINE ADULTES G Amyleine HCl - 0.01g, Eucalyptol - 0.05g, Camphre - 0.1g, Gaiacol ethyl glycolate - 0.26g, Aminophylline - 0.15g Suppository 326,362 L.L
R03DA55 CAMPHO-PNEUMINE AMINOPHYLLINE ADULTES G Amyleine HCl - 0.01g, Eucalyptol - 0.05g, Camphre - 0.1g, Gaiacol ethyl glycolate - 0.26g, Aminophylline - 0.15g Suppository 490,183 L.L
J01CR02 CURAM G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet, film coated 541,236 L.L
J01CR02 CURAM G Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet, film coated 402,189 L.L
C01BD01 CORDARONE B Amiodarone (HCl) - 200mg 200mg Tablet, scored 349,399 L.L
C01BD01 CORDARONE B Amiodarone (HCl) - 150mg/3ml 150mg/3ml Injectable concentrated solution 499,909 L.L
J01GB06 CHEMACIN G Amikacin (sulfate) - 500mg/2ml 500mg/2ml Injectable solution 1,679,803 L.L
C05BA53 CONTRACTUBEX B Allantoin - 1g/100g, Cepae - 10g/100g, Heparin - 5000IU/100g Gel 498,566 L.L
C05BA53 CONTRACTUBEX B Allantoin - 1g/100g, Cepae - 10g/100g, Heparin - 5,000IU/100g Gel 1,183,925 L.L
C01EB10 CARDESINE G Adenosine - 6mg/2ml 6mg/2ml Injectable solution 563,070 L.L
L04AB04 CINNORA BioTech Adalimumab - 40mg/0.8ml 40mg/0.8ml Injectable solution 14,817,734 L.L
D06BB03 CYCLOVEX G Aciclovir - 50mg/g 50mg/g Cream 345,560 L.L
D06BB03 CIVAR G Aciclovir - 5% 5% Cream 507,972 L.L
J05AB01 CYCLOVEX G Aciclovir - 400mg 400mg Tablet, scored 2,687,685 L.L
J05AB01 CYCLOVEX G Aciclovir - 200mg 200mg Tablet, scored 1,164,664 L.L
L01EL02 CALQUENCE B Acalabrutinib - 100mg 100mg Tablet, film coated 650,653,454 L.L
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