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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
B01AB11 ANGIOFLUX G Sulodexide - 250LRU 250LRU Capsule, soft 2,026,514 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 226,036 L.L
C08CA01 AMLODAR 10 G Amlodipine (besylate) - 10mg 10mg Capsule 671,921 L.L
C09DB07 CORONOPINE G Candesartan cilexetil - 16mg, Amlodipine - 10mg Capsule, hard 1,540,044 L.L
D04AB01 LIDONOSTRUM BOMBA-SPRAY G Lidocaine - 10% 100mg/ml Spray, solution 747,176 L.L
H02B PREDALONE PLUS G Prednisolone sodium phosphate - 10mg/5ml, Dexchlorpheniramine maleate - 2mg/5ml Syrup 890,776 L.L
L01BC07 ZYDROME G Azacitidine - 100mg 100mg Injectable lyophilised powder 10,967,854 L.L
N02BE01 SOLUFLEX PARACETAMOL G Paracetamol - 1g/100ml 1g/100ml Injectable solution 211,175 L.L
N05AH03 VAINCOR G Olanzapine - 5mg 5mg Tablet, coated, scored 806,306 L.L
N06BA09 PMS-ATOMOXETINE G Atomoxetine (HCl) - 25mg 25mg Capsule 4,121,565 L.L
A03FA07 GAROPRIDE G Itopride Hydrochloride - 50mg 50mg Tablet, film coated 213,671 L.L
A10BB12 GLYPRIDE G Glimepiride - 4mg 4mg Tablet 657,139 L.L
B01AB12 HIBOR G Bemiparin Sodium - 2,500IU 2,500IU Injectable solution 704,173 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 194,211 L.L
C08CA01 AMLODIPINE ARROW G Amlodipine (besylate) - 10mg 10mg Capsule 462,282 L.L
C09DB07 CORONOPINE G Candesartan cilexetil - 8mg, Amlodipine - 10mg Capsule, hard 1,368,032 L.L
D04AB01 PROCOMIL G Lidocaine - 10% 10% Spray 139,760 L.L
G03CA03 OESTRACLIN G Estradiol - 0.6mg/g 0.6mg/g Gel 448,843 L.L
J01DD15 MINOCET G Cefdinir - 300mg 300mg Capsule 1,407,003 L.L
M03AC09 ROCUCELL G Rocuronium bromide - 50mg/5ml 50mg/5ml Injectable solution 3,633,494 L.L
N02BE01 ? PARACETAMOL G Paracetamol - 1g/100ml 1g/100ml Injectable solution 191,978 L.L
N05AH03 ZOLAPINE G Olanzapine - 5mg 5mg Tablet, orodispersible 1,186,165 L.L
N06BA09 PMS-ATOMOXETINE G Atomoxetine (HCl) - 18mg 18mg Capsule 3,744,073 L.L
R03BB01 IPRAVENT G Ipratropium bromide - 20mcg/2ml 20mcg/2ml Inhalation solution 630,262 L.L
S01BC04 FLUROPTIC G Flurbiprofen sodium - 0.03% w/v 0.03% w/v Drops solution 223,078 L.L
A03FA08 CINITREX G Cinitapride - 1mg 1mg Tablet 636,981 L.L
A10BB12 JOSWE GLEMAX 4 G Glimepiride - 4mg 4mg Caplet 235,172 L.L
B01AB12 HIBOR G Bemiparin Sodium - 3,500IU 3,500IU Injectable solution 1,029,383 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 180,421 L.L
C08CA01 AMLODIPINE BIOGARAN G Amlodipine (besylate) - 10mg 10mg Capsule 462,282 L.L
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