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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
A10BD02 GLYSTOR PLUS G Metformin HCl - 500mg, Glibenclamide - 5mg Tablet, film-scored 691,119 L.L
B01AC04 APO-CLOPIDOGREL G Clopidogrel (Bisulfate), - 75mg 75mg Tablet 911,125 L.L
B05BB02 5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 179,272 L.L
C08CA05 NIFELAT R G Nifedipine - 20mg 20mg Tablet, sustained release 388,370 L.L
C09DX LOSANET AM PLUS G Losartan potassium - 100mg, Amlodipine - 5mg, Hydrochlorothiazide - 12.5mg Tablet 1,044,358 L.L
D04AB01 AVOCAINE G Lidocaine - 10% 10% Spray 400,465 L.L
J01DD15 MINOCET G Cefdinir - 300mg 300mg Capsule 1,407,003 L.L
J02AX04 CASPOFUNGINE STRAGEN G Caspofungin (acetate) - 70mg 70mg Injectable concentrated powder for solution 22,928,852 L.L
L01CB01 ETOPOSIDE VIATRIS 20MG/ML G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution 1,544,466 L.L
M03BX01 BACLOCALM G Baclofen - 25mg 25mg Tablet 928,595 L.L
N05AH04 QUETIAPINE BIOGARAN L.P. G Quetiapine fumarate - 300mg 300mg Tablet, prolonged release 1,759,090 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 4.5mg 4.5mg Capsule 842,589 L.L
R03DC03 MONTELUKAST-SANDOZ G Montelukast (sodium) - 4mg 4mg Tablet, chewable 1,184,140 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 100mg 100mg Injectable solution L.L
A04AA01 ODNATRON G Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 880,217 L.L
A10BD02 DIAMET 500/5 G Metformin HCl XR - 500mg, Glibenclamide - 5mg Tablet, film coated 639,925 L.L
B01AC04 CERUVIN G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 240,548 L.L
B05BB02 5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 224,090 L.L
C08CA05 NIFELAT 30 LA G Nifedipine - 30mg 30mg Tablet, prolonged release 1,007,882 L.L
D04AB01 LIDONOSTRUM BOMBA-SPRAY G Lidocaine - 10% 100mg/ml Spray, solution 747,176 L.L
G03CA03 VAGIFEM G Estradiol (hemihydrate) - 10mcg 10mcg Tablet 2,254,968 L.L
H02B PREDALONE PLUS G Prednisolone sodium phosphate - 10mg/5ml, Dexchlorpheniramine maleate - 2mg/5ml Syrup 890,776 L.L
J01DD15 SEFARIN G Cefdinir - 300mg 300mg Capsule 1,494,353 L.L
L01CD01 PACLITAXEL MYLAN PHARMA 6MG/ML G Paclitaxel - 300mg/50ml 300mg/50ml Injectable concentrated powder for solution 52,787,940 L.L
M03BX01 BACLOCALM G Baclofen - 10mg 10mg Tablet 589,947 L.L
N05AH04 REZAL XR G Quetiapine fumarate - 300mg 300mg Tablet, extended release 2,535,831 L.L
N06DA03 RIVASTIGMINE ARROW G Rivastigmine - 4.5mg 4.5mg Capsule 842,589 L.L
R03DC03 RELIEFAST G Montelukast (sodium) - 4mg 4mg Tablet, chewable 1,034,119 L.L
A04AA01 ONDANSETRON HIKMA G Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 2,228,091 L.L
B01AC04 CLODOR G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 1,148,025 L.L
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