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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
C07AA05 PROBETOL G Propranolol HCl - 10mg 10mg Tablet 126,705 L.L
D10BA01 CURACNE G Isotretinoin - 5mg 5mg Capsule, soft 856,028 L.L
J01MA12 JOSWE AVOXIN 750 G Levofloxacin - 750mg 750mg Tablet, film coated 1,550,794 L.L
L01EJ01 CELEZON G Ruxolitinib - 15mg 15mg Tablet 188,515,591 L.L
M01AE01 ? IBUPROFEN G Ibuprofen - 400mg/100ml 400mg/100ml Injectable solution 383,955 L.L
N02AA05 OXYCODONE RENAUDIN G Oxycodone HCl - 10mg/10ml 10mg/10ml Injectable solution 2,432,355 L.L
N03AX14 LEVIPRAM 500 G Levetiracetam - 500mg 500mg Tablet, film coated 1,663,805 L.L
R06AE09 LIVIDA G Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 447,948 L.L
A02BC05 PRIMAZOL 20 G Esomeprazole (magnesium dihydrate) - 20mg 20mg Capsule, gastro-resistant 511,940 L.L
A11CC05 VIDROP G Vitamin D3 - 100IU/drop 100IU/drop Drops 346,711 L.L
B03AE02 ELEVIT PRONATAL G Vitamin A, palmitate - 1080mcg, Vitamin B1 - 1.6mg, Vitamin B2 - 1.8mg, Vitamin B6 - 2.6mg, Vitamin B12 - 4mcg, Vitamin C - 100mg, Vitamin D3 - 12.5mcg, Vitamin E - 15mg, Biotin - 0.2mg, Calcium Pantothenate - 10mg, Folic acid - 0.8mg, Nicotinamide - 19mg, Calcium - 125mg, Magnesium - 100mg, Phosphorous - 125mg, Iron - 60mg, Copper - 1mg, Manganese - 1mg, Zinc - 7.5mg Tablet, film coated 893,655 L.L
B05XA02 SODIUM BICARBONATE G Sodium bicarbonate - 1.4g/100ml 1.4g/100ml Injectable solution 258,887 L.L
C07AA05 APO-PROPRANOLOL G Propranolol HCl - 40mg 40mg Tablet, scored 356,118 L.L
C10AB04 LOW-LIP G Gemfibrozil - 600mg 600mg Tablet, film coated 298,333 L.L
D10BA01 CURACNE G Isotretinoin - 5mg 5mg Capsule, soft gelatin 856,028 L.L
G04CA04 SILODOSINE ARROW G Silodosine - 4mg 4mg Capsule 732,394 L.L
J01DC10 CEFPROZ G Cefprozil - 500mg 500mg Tablet, film coated 1,737,588 L.L
J01MA12 LEFLUMAX G Levofloxacin (hemihydrate) - 750mg 750mg Tablet, film coated 1,006,538 L.L
L03AX16 PLERIXAFOR ARROW G Plerixafor - 20mg/ml 20mg/ml Injectable solution 289,660,995 L.L
N03AX14 ZITERA G Levetiracetam - 500mg 500mg Tablet, film coated 2,203,902 L.L
N06AB05 APO-PAROXETINE G Paroxetine (HCl) - 20mg 20mg Tablet 983,693 L.L
R01AD09 AVOCOM G Mometasone furoate - 0.05% 0.05% Spray 419,279 L.L
R06AE09 ZOLICIN G Levocetirizine dihydrochloride - 5mg 5mg Tablet, film coated 228,453 L.L
A11CC05 D-CURE G Vitamin D3 - 25,000IU 25,000IU Solution 467,657 L.L
B05XA03 0.9% SODIUM CHLORIDE INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 145,946 L.L
C07AA05 BEDRANOL G Propranolol HCl - 40mg 40mg Tablet, film coated 247,267 L.L
C09CA08 OLMENOR G Olmesartan medoxomil - 40mg 40mg Tablet, film coated 721,643 L.L
C10AB05 NANOFIB G Fenofibrate - 145mg 145mg Tablet, film coated 1,371,615 L.L
D10BA01 ISOSUPRA LIDOSE G Isotretinoin - 16mg 16mg Capsule, hard 1,826,282 L.L
G04CA04 SILODOSINE BIOGARAN G Silodosine - 4mg 4mg Capsule 555,007 L.L
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