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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
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 2.5g/50ml 5% Injectable solution 14,850,456 L.L
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 5g/100ml 5% Injectable solution L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard 417,741,356 L.L
L01EA05 ICLUSIG B Ponatinib - 45mg 45mg Tablet, film coated 207,092,651 L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated L.L
L01EL01 IMBRUVICA B Ibrutinib - 420mg 420mg Tablet, film coated 584,283,050 L.L
L01CE02 IRINOTECAN THYMOORGAN G Irinotecan HCl - 40mg/2ml 40mg/2ml Injectable concentrated solution 2,123,271 L.L
L01CE02 IRNOCAM 40 G Irinotecan HCl - 40mg/2ml 40mg/2ml Injectable solution 908,694 L.L
A02BC01 IPPROTON G Omeprazole - 40mg 40mg Injectable lyophilised powder 6,533,762 L.L
M01AE01 IBUPROFEN B. BRAUN G Ibuprofen - 400mg/100ml 400mg/100ml Injectable solution 231,141 L.L
L01EA01 IMAREM G Imatinib (mesylate) - 400mg 400mg Tablet, film coated 64,682,117 L.L
L01EA01 IMATINIB GP PHARM G Imatinib - 400mg 400mg Tablet, coated 26,083,945 L.L
L01EA01 IMATINIB NEAPOLIS G Imatinib - 400mg 400mg Tablet, film coated 36,046,335 L.L
L01EA01 IMATINIB SHILPA MESYLATE G Imatinib - 400mg 400mg Tablet, film coated 21,518,059 L.L
L01EA01 IMATINIB SPC G Imatinib - 400mg 400mg Tablet, film coated 62,161,280 L.L
N05AX13 INVEGA B Paliperidone - 3mg 3mg Tablet, extended release 5,386,121 L.L
P02CF01 IVERMECTINE BIOGARAN G Ivermectin - 3mg 3mg Tablet 1,075,074 L.L
N05CF04 INDUCTAL G Eszopiclone - 3mg 3mg Tablet, film coated 1,693,242 L.L
R07AA INFASURF B Calfactant - 210mg/6ml 35mg/ml Injectable suspension 40,596,749 L.L
R07AA INFASURF B Calfactant - 105mg/3ml 35mg/ml Injectable suspension 23,344,161 L.L
R05CA12 IVY-CALM G Dried Ivy leaf extract - 35mg/5ml 35mg/5ml Syrup 251,299 L.L
C09CA04 IBECARD 300- IPS G Irbesartan - 300mg 300mg Tablet, film coated 564,414 L.L
C09CA04 IRBAVEL 300 G Irbesartan - 300mg 300mg Tablet, film coated 564,414 L.L
C09CA04 IRBESARTAN ARROW G Irbesartan - 300mg 300mg Tablet 470,345 L.L
C09CA04 IRTAN G Irbesartan - 300mg 300mg Tablet 554,175 L.L
C09DA04 IRTAN PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 25mg 300mg Tablet 601,530 L.L
J06BB01 IMMUNORHO BioHuman Human anti-D (rh) immunoglobulin - 300mcg 300mcg Injectable dry powder+diluent 5,794,649 L.L
A07DA03 IMODIUM B Loperamide HCl - 2mg 2mg Capsule 138,416 L.L
A07DA03 IMODIUM INSTANTS B Loperamide HCl - 2mg 2mg Tablet, orodispersible 451,531 L.L
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