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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
C09DB07 CANDAM G Candesartan cilexetil - 8mg, Amlodipine - 5mg Capsule, hard 1,376,095 L.L
D04AA32 DERMAMINE ITCH STOPPING G Diphenhydramine HCl - 1%, Zinc acetete - 0.1% Cream 560,382 L.L
G03AD01 PURPLE LINE G Levonorgestrel - 1.5mg 1.5mg Tablet, film coated 1,071,570 L.L
H02AB09 HYDROCORTISONE ORBUCELL G Hydrocortisone (sodium succinate) - 100mg 100mg Injectable powder 1,091,712 L.L
J01DD15 SEFARIN G Cefdinir - 125mg/5ml 125mg/5ml Suspension 1,695,929 L.L
L01BC07 AZACITIDINE EVER PHARMA G Azacitidine - 100mg/100ml 25mg/ml Injectable powder for suspension 10,967,854 L.L
N02BE01 PARACETAMOL MACOPHARMA G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 9,350,840 L.L
N06BA09 APO-ATOMOXETINE G Atomoxetine (HCl) - 60mg 60mg Capsule 4,731,669 L.L
S01BA07 OPTILONE G Fluorometholone - 0.1% 0.1% Solution 309,084 L.L
A03FA03 DOMIDONE CHAPHA SUGAR FREE G Domperidone - 5mg/5ml 5mg/5ml Suspension 319,963 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 189,262 L.L
B05ZA CONCENTRATE SOLUTIONFOR HEMODIALYSIS TYPE A G Hemodialytics, concentrates - Injectable solution L.L
C08CA01 NIPIDOL G Amlodipine - 5mg 5mg Tablet 255,330 L.L
C09DB07 CORONOPINE G Candesartan cilexetil - 8mg, Amlodipine - 5mg Capsule, hard 1,368,032 L.L
D04AA32 HISTERGAN G Diphenhydramine HCl - 2% 2% Cream 546,944 L.L
J01DD15 SEFARIN G Cefdinir - 125mg/5ml 125mg/5ml Suspension 939,346 L.L
J02AC03 VIROZOLE 200 G Voriconazole - 200mg 200mg Tablet, film coated 47,909,207 L.L
L01BC07 AZACITIDINE NEAPOLIS G Azacitidine - 100mg 100mg Injectable lyophilised powder 9,401,575 L.L
M02AA15 DILO G Diclofenac sodium - 2% 2% Gel 267,489 L.L
N02BE01 PARACETAMOL NORMON G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 9,633,134 L.L
N06BA09 PMS-ATOMOXETINE G Atomoxetine (HCl) - 60mg 60mg Capsule 5,228,891 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule L.L
A03FA03 FARCOTILIUM G Domperidone - 5mg/5ml 5mg/5ml Suspension 115,570 L.L
A10BB12 AMEPRIDE G Glimepiride - 4mg 4mg Tablet 215,015 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 182,720 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE B+ G Hemodialytics, concentrates - Injectable solution L.L
C08CA01 TORANS G Amlodipine (besylate) - 5mg 5mg Tablet 518,339 L.L
C09DB07 CANDAM G Candesartan cilexetil - 16mg, Amlodipine - 5mg Capsule, hard 1,376,095 L.L
D04AA32 HISTAFEN G Diphenhydramine HCl - 2% 2% Solution 362,837 L.L
G03AD02 ECINQ G Ulipristal acetate - 30mg 30mg Tablet, film coated 1,302,183 L.L
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