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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
N05AX13 INVEGA B Paliperidone - 9mg 9mg Tablet, extended release 5,825,557 L.L
C08DA01 ISOPTIN B Verapamil (HCl) - 80mg 80mg Tablet, film coated 397,704 L.L
N05AX13 INVEGA SUSTENNA B Paliperidone palmitate - 75mg 75mg Injectable suspension, prolonged release 15,240,102 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Capsule 172,164,216 L.L
L01EF01 IBRANCE B Palbociclib - 75mg 75mg Tablet, film coated 172,164,216 L.L
C01EB17 IVABRADINE ARROW G Ivabradine (HCl) - 7.5mg 7.5mg Tablet, film coated, scored 1,323,685 L.L
N05AX13 INVEGA B Paliperidone - 6mg 6mg Tablet, extended release 5,825,557 L.L
P02CF01 IVER G Ivermectin - 6mg 6mg Tablet 431,373 L.L
P02CF01 IVERMECTIN BENTA G Ivermectin - 6mg 6mg Tablet 784,548 L.L
P02CF01 IVERMECTIN BENTA G Ivermectin - 6mg 6mg Tablet 470,985 L.L
G03AC08 IMPLANON NXT B Etonogestrel - 68mg 68mg Implant 12,299,971 L.L
M01AE01 IBUPROFEN B. BRAUN G Ibuprofen - 600mg/100ml 600mg/100ml Injectable solution 550,975 L.L
B02BD04 IMMUNINE BioHuman Plasma coagulation factor IX, human - 600IU 600IU Injectable lyophilised powder for solution+diluent 20,506,214 L.L
N05CD08 IPNODIS MEDIS G Midazolam - 5mg/ml 5mg/ml Injectable solution 565,758 L.L
A10BH05 INAGLIP G Linagliptin - 5mg 5mg Tablet, film coated 1,242,606 L.L
L01EK01 INLYTA B Axitinib - 5mg 5mg Tablet, film coated 184,486,511 L.L
C01EB17 IVABRADINE ARROW G Ivabradine (HCl) - 5mg 5mg Tablet, film coated, scored 1,323,685 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 5g/100ml 5g/100ml Injectable solution 28,622,366 L.L
M02AA13 IBUSTICK G Ibuprofen - 50mg/g 50mg/g Gel, roll on 857,372 L.L
N05AX13 INVEGA SUSTENNA B Paliperidone palmitate - 50mg 50mg Injectable suspension, prolonged release 9,661,754 L.L
L04AX01 IMURAN B Azathioprine - 50mg 50mg Tablet 2,030,546 L.L
N02CC01 IMIGRAN B Sumatriptan (succinate) - 50mg 50mg Tablet, film coated 378,964 L.L
J06BB04 IMMUNOGLOBULINE HUMAINE DE L'HEPATITE B LFB BioHuman Hepatitis B immunoglobulin (human) - 500UI/5ml 500UI/5ml Injectable solution 26,599,935 L.L
L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution L.L
L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution L.L
L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution 227,939,689 L.L
L01FF03 IMFINZI BioTech Durvalumab - 500mg/10ml 500mg/10ml Injectable solution 227,939,689 L.L
J01MA12 ILFLOX G Levofloxacin - 500mg 500mg Tablet, film coated 587,259 L.L
L04AA06 IMUNOCELL G Mycophenolate mofetil - 500mg 500mg Tablet, film coated 3,791,428 L.L
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 5g/100ml 5% Injectable solution 29,700,912 L.L
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