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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
A10BB12 GLUMYL 2 G Glimepiride - 2mg 2mg Tablet 189,418 L.L
B05BB01 SOLUFLEX 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 264,311 L.L
C08CA01 AMLOCARD G Amlodipine (besylate) - 5mg 5mg Tablet 473,545 L.L
D02AF VERRUFILM G Lactic acid - 16.7%, Salicylic acid - 16.7% Solution 861,403 L.L
G02CB03 PROCTINMED G Cabergoline - 0.5mg 0.5mg Tablet 1,689,402 L.L
H02AB06 XILONE FORTE G Prednisolone sodium phosphate - 15mg/5ml 15mg/5ml Solution 413,903 L.L
J01DD08 WINEX G Cefixime (trihydrate) - 400mg 400mg Capsule 1,307,559 L.L
J02AC01 ORAMAX G Fluconazole - 150mg 150mg Capsule 170,668 L.L
L01BC06 CAPECITABINE ACCORD G Capecitabine - 500mg 500mg Tablet, film coated 10,908,012 L.L
N02BE01 PARAMOL G Paracetamol - 120mg/5ml 120mg/5ml Syrup, alcohol free 85,750 L.L
N06AX26 LYTIOX G Vortioxetine - 20mg 20mg Tablet, film coated 3,290,622 L.L
R03BA02 BUDENA G Budesonide - 200mcg/actuation 200mcg/actuation Inhalation suspension 1,065,667 L.L
S01AE07 AROX G Moxifloxacin (HCl) - 0.5% 0.5% Drops 423,310 L.L
A03FA01 VOMICARE INJECTION BP IM/IV G Metoclopramide - 10mg/2ml 10mg/2ml Injectable solution 247,267 L.L
A10BB12 GLYPRIDE G Glimepiride - 2mg 2mg Tablet 403,153 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 129,934 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE C G Potassium chloride - 2.611g/l, Magnesium chloride, 6H2O - 5.33g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 190.505g/l, Sodium chloride - 204.54g/l Injectable solution L.L
C08CA01 AMLOCOEUR G Amlodipine - 5mg 5mg Tablet 362,198 L.L
H02AB07 PREDICOR G Prednisone - 5mg 5mg Tablet, scored 174,060 L.L
J01DD13 CEFODOX G Cefpodoxime (proxetil) - 100mg 100mg Tablet 434,061 L.L
J02AC01 PANZIMOL G Fluconazole - 150mg 150mg Capsule, hard 428,686 L.L
L01BC06 CAPECITABINE BIOGARAN G Capecitabine - 500mg 500mg Tablet, coated 12,123,049 L.L
M02AA10 ACHONID GEL G Ketoprofen - 2.5% 2.5% Gel 179,179 L.L
N02BE01 PAROL INFANTS G Paracetamol - 120mg/5ml 120mg/5ml Syrup 281,567 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
S01AE07 FORTYMOX G Moxifloxacin (HCl) - 0.5% 0.5% Drops solution 772,709 L.L
A03FA01 ? METOCLOPRAMIDE INJECTION USP G Metoclopramide HCl - 10mg/2ml 10mg/2ml Injectable solution 84,470 L.L
A10BB12 JOSWE GLEMAX 2 G Glimepiride - 2mg 2mg Caplet 139,760 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 205,933 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE D G Potassium chloride - 5.215g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 166.7g/l, Sodium chloride - 214.76g/l Injectable solution L.L
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