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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
J01DD15 XEVANEER G Cefdinir - 125mg/5ml 125mg/5ml Powder for suspension 1,308,903 L.L
J02AC03 VORICONAZOLE STRAGEN G Voriconazole - 200mg 200mg Tablet, coated 41,794,841 L.L
L01BC07 AZACITIDINE SHILPA G Azacitidine - 100mg 100mg Injectable powder 7,350,062 L.L
N02BE01 PARACETAMOL PANPHARMA G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 8,675,675 L.L
N05AH03 APO-OLANZAPINE ODT G Olanzapine - 5mg 5mg Tablet, orally disintegrating 1,463,444 L.L
N06BA09 APO-ATOMOXETINE G Atomoxetine (HCl) - 40mg 40mg Capsule 4,114,846 L.L
A03FA03 MOTIDOL ODT G Domperidone - 10mg 10mg Tablet, orodispersible 259,810 L.L
A10BB12 DIAMERIL G Glimepiride - 4mg 4mg Tablet 322,522 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 207,894 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE J G Hemodialytics, concentrates - Injectable solution L.L
C08CA01 AMLINE G Amlodipine - 10mg 10mg Tablet 662,962 L.L
C09DB07 CORONOPINE G Candesartan cilexetil - 16mg, Amlodipine - 5mg Capsule, hard 1,638,144 L.L
J01DD15 XEVANEER G Cefdinir - 125mg/5ml 125mg/5ml Powder for suspension 686,704 L.L
L01BC07 AZACITIDINE SPC G Azacitidine - 100mg 100mg Injectable powder 10,706,993 L.L
N02BE01 PARACETAMOL PANPHARMA G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 2,215,996 L.L
N05AH03 OLANZAX 5 G Olanzapine - 5mg 5mg Tablet, mouth dissolving 1,316,966 L.L
N06BA09 PMS-ATOMOXETINE G Atomoxetine (HCl) - 40mg 40mg Capsule 4,706,136 L.L
A10BB12 GLIM G Glimepiride - 4mg 4mg Tablet 628,918 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 198,578 L.L
C08CA01 AMLOCARD 10 G Amlodipine (besylate) - 10mg 10mg Tablet 870,298 L.L
C09DB07 CANDAM G Candesartan cilexetil - 16mg, Amlodipine - 10mg Capsule, hard 1,376,095 L.L
D04AB01 AVOCAINE G Lidocaine - 10% 10% Spray 400,465 L.L
J02AC03 VORICONAZOLE STRAGEN G Voriconazole - 200mg 200mg Injectable powder for solution 5,841,683 L.L
L01BC07 MATURUS G Azacitidine - 100mg 100mg Injectable lyophilised powder 9,401,575 L.L
N02BE01 PARAMED G Paracetamol - 10mg/ml 10mg/ml Injectable solution 814,369 L.L
N05AH03 PRANZA G Olanzapine - 5mg 5mg Tablet, orodispersible 1,773,872 L.L
N06BA09 APO-ATOMOXETINE G Atomoxetine (HCl) - 25mg 25mg Capsule 3,703,630 L.L
R03BB01 IPRATROPIUM ARROW ADULTES G Ipratropium bromide - 0.5mg/2ml 0.5mg/2ml Inhalation solution for nebuliser 303,708 L.L
S01BC03 DICLOFTIL G Diclofenac sodium - 0.1% 0.1% Drops solution 1,038,790 L.L
A10BB12 GLUMYL 4 G Glimepiride - 4mg 4mg Tablet 317,403 L.L
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