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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
R06AX DESLAMED FORTE G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 673,201 L.L
L04AX04 LENOMA G Lenalidomide - 15mg 15mg Capsule, hard L.L
A02BC05 ESOMEPRAZOLE BIOGARAN G Esomeprazole (magnesium dihydrate) - 40mg 40mg Capsule, gastro-resistant 513,348 L.L
A11CC05 DIBASE G Vitamin D3 - 100,000IU/ml 100,000IU/ml Injectable solution 354,774 L.L
B03BB01 FOLICIL G Folic acid - 5mg 5mg Tablet 584,571 L.L
B05XA03 0.9% SODIUM CHLORIDE INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 222,941 L.L
C07AB02 B-BLOK SDK G Metoprolol succinate - 25mg 25mg Tablet, controlled release 282,207 L.L
C09DA01 LOSARTAN/HYDROCHLOROTHIAZIDE REMEDICA G Losartan potassium - 50mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 635,638 L.L
J01DD02 FORTECARE G Ceftazidime - 1g 1g Injectable powder for solution 10,011,695 L.L
J01MA14 FLOXIMOX G Moxifloxacin (HCl) - 400mg 400mg Tablet, film coated 1,062,276 L.L
L04AA06 MYORA G Mycophenolate mofetil - 500mg 500mg Tablet, film coated 3,643,157 L.L
N03AX14 LEPITAM G Levetiracetam - 100mg/ml 100mg/ml Solution 1,336,163 L.L
R01AD11 RINEX G Triamcinolone acetonide - 55mcg/actuation 55mcg/actuation Spray, suspension 470,985 L.L
R06AX DESLOCORT G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 1,009,802 L.L
A02BC05 EXONAR G Esomeprazole (magnesium trihydrate) - 40mg 40mg Capsule, delayed release 639,925 L.L
A11CC06 HIDROFEROL G Calcifediol - 0.266mg 0.266mg Capsule, soft 1,316,966 L.L
B03BB01 MED-FOLIC ACID G Folic acid - 5mg 5mg Tablet, scored 355,798 L.L
B05XA03 0.9% SODIUM CHLORIDE INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 181,570 L.L
C10AB05 FENOGAL G Fenofibrate micronised - 200mg 200mg Capsule, micronized 392,402 L.L
D11AH01 TACRUS G Tacrolimus monohydrate - 0.1% 0.1% Ointment 1,857,190 L.L
G04CB01 FINASTEKERN G Finasteride - 5mg 5mg Tablet, film coated 560,382 L.L
J01DD02 NEGACEF G Ceftazidime (pentahydrate) - 1g 1g Injectable dry powder for solution 4,421,242 L.L
J01MA14 LOXIMED G Moxifloxacin (HCl) - 400mg 400mg Tablet 851,100 L.L
L01AA09 BENDAMUSTINE HYDROCHLORIDE G Bendamustine HCl - 25mg/10ml 25mg/10ml Injectable powder for concentrate for solution 19,610,153 L.L
M01AE02 NAPROXENE SODIQUE ARROW G Naproxen (sodium) - 550mg 550mg Tablet, film coated, scored 255,330 L.L
N02AF02 NALBUPHINE RENAUDIN 1% G Nalbuphine HCl - 20mg/2ml 20mg/2ml Injectable solution 1,181,238 L.L
N03AX14 LEVETIRACETAM ARROW G Levetiracetam - 100mg/ml 100mg/ml Solution 1,639,488 L.L
R06AX DESLOCORT G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 673,201 L.L
A02BC05 METAPRO G Esomeprazole - 40mg 40mg Tablet, gastroresistant 639,669 L.L
A11CC06 DEDROGYL G Calcifediol - 15mg/100ml 15mg/100ml Drops solution 827,807 L.L
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