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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
L01BC05 GEMTABINE 1000 G Gemcitabine HCl - 1,000mg 1,000mg Injectable lyophilised powder for solution 4,882,628 L.L
N02BE01 BBDOL-OR G Paracetamol - 120mg/5ml 120mg/5ml Syrup 188,138 L.L
N05AE05 LAROZA G Lurasidone - 80mg 80mg Tablet, film coated 5,548,726 L.L
R03BA01 CORTIS G Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 674,609 L.L
S01AE02 NAFLOX G Norfloxacin - 3mg/ml 3mg/ml Drops 370,901 L.L
A03FA01 METOCLOPRAMIDE S.A.L.F. G Metoclopramide HCl - 10mg/2ml 10mg/2ml Injectable solution 255,330 L.L
A10BB12 DIAMERIL G Glimepiride - 2mg 2mg Tablet 199,657 L.L
B05BB01 LR G Sodium lactate - 0.3g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 234,862 L.L
B05XA31 NUTRYELT G Zinc (gluconate) - 10000mcg/10ml, Copper (gluconate) - 300mcg/10ml, Manganese (gluconate) - 55mcg/10ml, Sodium fluoride - 950mcg/10ml, Iodine potassium iodide - 130mcg/10ml, Selenium (sodium salt) - 70mcg/10ml, Molybdenum (Sodium molybdate) - 20mcg/10ml, Chrome (chlorure) - 10mcg/10ml, Ferrous (gluconate) - 1000mcg/10ml Injectable concentrate for solution 3,483,240 L.L
C08CA01 AMLINE G Amlodipine - 5mg 5mg Tablet, scored 358,358 L.L
D02AF METHYL SALICYLATE COMPOUND UNGUENTUM G Methylsalicylate - 4.5g/30g, Menthol - 1.8g/30g Ointment 165,101 L.L
G02CB03 PROCTIN G Cabergoline - 0.5mg 0.5mg Tablet 1,300,328 L.L
H02AB06 PREDO G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Syrup 1,018,633 L.L
J01DD08 MAGNACEF 400 G Cefixime - 400mg 400mg Capsule 1,307,559 L.L
J02AC01 FUNZOL 150 G Fluconazole - 150mg 150mg Capsule 170,668 L.L
L01BC05 HAXANIT G Gemcitabine (HCl) - 1g 1g Injectable lyophilised powder 6,829,408 L.L
M02AA07 PIROXICALM G Piroxicam - 0.5% 0.5% Gel 207,336 L.L
N02BE01 PAINOL G Paracetamol - 120mg/5ml 120mg/5ml Elixir 85,750 L.L
N05AE05 LURABIL G Lurasidone - 80mg 80mg Tablet, film coated 2,535,831 L.L
N06AX26 LYTIOX G Vortioxetine - 10mg 10mg Tablet, film coated 2,064,142 L.L
R03BA02 AERONIDE G Budesonide - 200mcg 200mcg Capsule, inhalation 1,150,329 L.L
A03FA01 METORAM G Metoclopramide HCl - 10mg/2ml 10mg/2ml Injectable solution 421,071 L.L
A10BB12 GLIM G Glimepiride - 2mg 2mg Tablet 401,809 L.L
B05BB01 SERUFLEX 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 232,134 L.L
B05XA31 ADDAVEN G Chromic chloride 6H2O - 53mcg/10ml, Copper chloride dihydrate - 1.02mg/10ml, Ferric Chloride hexahydrate - 5.40mg/10ml, Manganese chloride 4H2O - 198mcg/10ml, Potassium iodide - 166mcg/10ml, Sodium fluoride - 2.10mg/10ml Injectable concentrate for solution 4,065,124 L.L
C08CA01 AMLO TAD G Amlodipine besylate - 5mg 5mg Tablet 744,489 L.L
C09DB02 OLMENOR COMBI G Olmesartan medoxomil - 20mg, Amlodipine - 5mg Tablet, film coated 679,984 L.L
D02AF POMMADE ACIDE SALICYLIQUE G Salicylic acid - 10% 10% Ointment 284,127 L.L
G02CB03 PROCTINMED G Cabergoline - 0.5mg 0.5mg Tablet 473,545 L.L
H02AB06 PREDOXONE G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Solution 417,231 L.L
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