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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
B05XA03 0.9% SODIUM CHLORIDE INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 141,349 L.L
C07AB03 APO-ATENOL G Atenolol - 50mg 50mg Tablet 327,898 L.L
C09DA01 LOSANET-H FORTE G Losartan potassium - 100mg, Hydrochlorothiazide - 12.5mg Tablet 395,474 L.L
C10AC01 RESINCOLESTIRAMINA G Cholestyramine - 4g 4g Powder for suspension 2,998,113 L.L
G04CB01 FINASTERIDE G Finasteride - 5mg 5mg Tablet, film coated 356,118 L.L
J01DD04 LEBACEF G Ceftriaxone (sodium) - 0.5g, Lidocaine (ampoule) - 0.5g Injectable powder for solution+diluent 511,940 L.L
J01MA14 LOXIPHAR G Moxifloxacin (HCl) - 400mg 400mg Tablet 1,063,555 L.L
L01AA09 BENDAMUSTINE MEDAC G Bendamustine HCl - 2.5mg/ml (25mg) 2.5mg/ml Injectable powder for concentrate for solution 24,934,922 L.L
L04AA10 SIROMUNE G Sirolimus - 1mg 1mg Tablet, film coated 18,729,193 L.L
M01AE02 ANODYNE 500 G Naproxen - 500mg 500mg Suppository 342,680 L.L
N03AX14 LEVETRIMED G Levetiracetam - 100mg/ml 100mg/ml Solution 1,336,163 L.L
R06AX FRENALER CORT G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 741,801 L.L
A02BC05 PRIMAZOL 40 G Esomeprazole (magnesium dihydrate) - 40mg 40mg Capsule, gastro-resistant 639,925 L.L
B05XA03 CHLORURE DE SODIUM 0.9 pour cent Renaudin G Sodium chloride - 0.9% 0.9% Injectable solution 385,683 L.L
C07AB03 ATENOLOL BIOGARAN G Atenolol - 50mg 50mg Tablet, scored 295,645 L.L
C09DA01 LOSARTAN/HYDROCHLOROTHIAZIDE ARROW LAB G Losartan potassium - 100mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 470,345 L.L
G04CB01 FINASTERIDE ARROW LAB G Finasteride - 5mg 5mg Tablet, film coated 516,036 L.L
J01DD04 LEBACEF G Ceftriaxone (sodium) - 0.5g 0.5g Injectable powder for solution+diluent 511,940 L.L
J01MA14 QUINOMOX G Moxifloxacin (HCl) - 400mg 400mg Tablet, film coated 912,469 L.L
L01EX01 SOVIDEX G Sunitinib maleate - 12.5mg 12.5mg Capsule 36,042,560 L.L
N03AX14 LEVIPRAM G Levetiracetam - 100mg/ml 100mg/ml Solution 1,285,609 L.L
N06AB06 DEPRINE G Sertraline HCl - 50mg 50mg Tablet 894,615 L.L
R06AX ORADUS BETA G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Solution 639,925 L.L
A02BC05 PUMPINOX G Esomeprazole - 40mg 40mg Tablet, enteric coated 649,076 L.L
B05XA03 CHLORURE DE SODIUM PROAMP G Sodium chloride - 0.9% 0.9% Injectable solution 1,104,639 L.L
C07AB03 ATONIUM G Atenolol - 50mg 50mg Tablet 239,588 L.L
C09DA01 LOSARTAN/HYDROCHLOROTHIAZIDE BGR G Losartan potassium - 100mg, Hydrochlorothiazide - 25mg Tablet, coated 439,436 L.L
G04CB01 STERIFINE 5 G Finasteride - 5mg 5mg Tablet, film coated 733,354 L.L
J01DD04 LEBACEF G Ceftriaxone (sodium) - 0.5g 0.5g Injectable powder for solution 3,455,595 L.L
L01EX01 SUNITINIB AQVIDA G Sunitinib maleate - 12.5mg 12.5mg Capsule, hard 41,692,397 L.L
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