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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
C09DX LOSANET AM PLUS G Losartan potassium - 100mg, Amlodipine - 10mg, Hydrochlorothiazide - 12.5mg Tablet 1,044,358 L.L
J01DD15 SEFARIN G Cefdinir - 300mg 300mg Capsule 1,494,353 L.L
M03AC09 RUCORON G Rocuronium bromide - 50mg/5ml 50mg/5ml Injectable solution 3,711,693 L.L
N05AH03 ZYRWAN OD G Olanzapine - 5mg 5mg Tablet, orodispersible 831,391 L.L
N06BA09 APO-ATOMOXETINE G Atomoxetine (HCl) - 10mg 10mg Capsule 2,981,987 L.L
S01CA01 API-TOBRASON G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 294,302 L.L
A10BB12 ORBIDE G Glimepiride - 4mg 4mg Tablet 357,078 L.L
B01AB12 HIBOR G Bemiparin Sodium - 5,000IU 5,000IU Injectable solution 1,466,132 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 186,167 L.L
C08CA01 AMLOKEY G Amlodipine (besylate) - 10mg 10mg Tablet 397,777 L.L
C09DX LOSANET AM PLUS G Losartan potassium - 100mg, Amlodipine - 5mg, Hydrochlorothiazide - 12.5mg Tablet 1,044,358 L.L
G03CA03 VAGIFEM G Estradiol (hemihydrate) - 10mcg 10mcg Tablet 2,254,968 L.L
J01DD15 XEVANEER G Cefdinir - 300mg 300mg Capsule 1,350,562 L.L
N05AH03 OLANZAMED G Olanzapine - 20mg 20mg Tablet 3,941,938 L.L
N06BX03 CEBROTONIN G Piracetam - 800mg 800mg Tablet, film coated 577,852 L.L
R03BB04 INHALEX G Tiotropium bromide - 18mcg 18mcg Capsule, inhalation 1,906,913 L.L
S01CA01 CO-AVAZIR G Tobramycin - 0.3%, Dexamethasone - 0.1% Drops suspension 193,513 L.L
A10BB12 JOSWE GLEMAX 6 G Glimepiride - 6mg 6mg Caplet 663,858 L.L
B01AB12 HIBOR G Bemiparin Sodium - 7,500IU 7,500IU Injectable solution 2,198,526 L.L
B05BB02 MIXTE SIMPLE (2) G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 182,720 L.L
C08CA01 AMLORINE 10 G Amlodipine (besylate) - 10mg 10mg Tablet 959,504 L.L
D04AB01 LIDONOSTRUM G Lidocaine - 50mg/g 50mg/g Ointment 1,069,699 L.L
G03CA03 MONTADIOL G Estradiol - 0.01% 0.01% Cream 1,105,982 L.L
J02AX04 CANDIGARD G Caspofungin (acetate) - 70mg 70mg Injectable powder for concentrate for solution 22,127,179 L.L
N02BE01 PARACEROL G Paracetamol - 10mg/ml 10mg/ml Injectable solution 1,536,012 L.L
N06BX06 CEROLINE G Citicoline - 100mg/ml 100mg/ml Solution 894,615 L.L
R03BB04 TIOVA-T G Tiotropium bromide monohydrate - 18mcg 18mcg Rotacaps 384,339 L.L
S01CA01 DEXATOBRIN G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 239,204 L.L
A04AA01 APO-ONDANSETRON G Ondansetron - 8mg 8mg Tablet 1,491,665 L.L
B05BB02 MIXTE SIMPLE (2) G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 207,894 L.L
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