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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
D01BA02 LAMIFEN G Terbinafine HCl - 250mg 250mg Tablet 245,923 L.L
H02AB04 MP 500 G Methylprednisolone - 500mg 500mg Injectable powder for solution 5,316,241 L.L
J01DD08 WINEX G Cefixime (trihydrate) - 200mg 200mg Capsule 731,050 L.L
J02AC01 FAZOL 150 G Fluconazole - 150mg 150mg Capsule 623,468 L.L
L01BC05 HAXANIT G Gemcitabine (HCl) - 200mg 200mg Injectable lyophilised powder 1,411,035 L.L
M01AH05 ETOXIB G Etoricoxib - 120mg 120mg Tablet, film coated 425,998 L.L
N02BE01 ALGIVIC INFANT G Paracetamol - 125mg 125mg Suppository 199,657 L.L
N05AD01 HALOPERIDOL G Haloperidol - 2mg 2mg Tablet 252,130 L.L
N06AX21 LOXYT 30 G Duloxetine HCl - 30mg 30mg Capsule, delayed release 716,716 L.L
R03AL02 IPRASAL VEM G Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide (monohydrate) - 0.5mg/2.5ml Inhaltion solution with nebuliser 417,935 L.L
S01AD09 GANVIR G Ganciclovir - 0.15% 0.15% Gel 698,798 L.L
A10BB12 DIAMERIL G Glimepiride - 1mg 1mg Tablet 130,545 L.L
B05BB01 LACTATED RINGER'S INJECTION, USP G Sodium lactate - 3.1g/l, Calcium chloride, 2H2O - 0.2g/l, Potassium chloride - 0.3g/l, Sodium chloride - 6g/l Injectable solution 216,046 L.L
B05XA05 MAGNESIUM SULFATE G Magnesium sulfate, 7H2O - 15g/100ml 15g/100ml Injectable solution 756,160 L.L
C09DB01 ARBITEN AM 10/160 G Amlodipine - 10mg, Valsartan - 160mg Caplet, film coated 857,372 L.L
D01BA02 LAMINOX G Terbinafine HCl - 250mg 250mg Tablet 725,675 L.L
J02AC01 FLOCAZOLE G Fluconazole - 150mg 150mg Capsule 172,012 L.L
L01BC05 GEMCI-CELL G Gemcitabine (HCl) - 1g/Vial 1g/Vial Injectable concentrate for solution 9,326,123 L.L
M01AH05 JOSWE COXIT 120 G Etoricoxib - 120mg 120mg Tablet, film coated 517,379 L.L
N02BE01 PARA-DENK 125 SUPPOS. G Paracetamol - 125mg 125mg Suppository 190,826 L.L
N05AD01 HALOPERIDOL G Haloperidol - 10mg 10mg Tablet 339,160 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 30mg 30mg Capsule, delayed release 642,357 L.L
A03E ACTICARBINE G Activated charcoal - 70mg, Papaverine HCl - 14mg Tablet, coated 311,771 L.L
A10BB12 GLIM G Glimepiride - 1mg 1mg Tablet 302,365 L.L
B05BB01 LR G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 218,681 L.L
B05XA05 SULFATE DE MAGNESIUM PROAMP G Magnesium sulfate - 0.15g/ml 0.15g/ml Injectable solution 1,400,284 L.L
C09DB01 LOTEVAN G Amlodipine - 10mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
D01BA02 TERAFAN G Terbinafine HCl - 250mg 250mg Tablet, scored 725,675 L.L
H02AB04 METHYL PREDNISOLONE VIATRIS 1G G Methylprednisolone (hemisuccinate) - 1g 1g Injectable dry powder for solution 1,348,604 L.L
J02AC01 FLUCOKEY G Fluconazole - 150mg 150mg Capsule 103,476 L.L
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