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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
A11A BEBE-VIT G Vitamin A - 1500IU/ml, Vitamin D3 - 400IU/ml, Vitamin E - 5mg/ml, Vitamin C - 40mg/ml, Vitamin B1 - 0.5mg/ml, Vitamin B2 - 0.6mg/ml, Vitamin B6 - 0.6mg/ml, Nicotinamide - 8mg/ml Drops 287,582 L.L
B03AA07 PEDIAFER G Ferrous (sulfate) - 15mg/ml 15mg/ml Drops 550,975 L.L
B03AB05 ENRICH N G Iron trivalent (hydroxide polymaltose complex) - 50mg/ml 50mg/ml Drops 459,594 L.L
A11CC05 VIDROP G Vitamin D3 - 100IU/drop 100IU/drop Drops 346,711 L.L
S01AA12 TOBRACIN G Tobramycin - 0.3% 0.3% Drops 322,522 L.L
S01AA12 TOBRIN G Tobramycin - 0.3% 0.3% Drops 169,324 L.L
S01AA13 FUCITHALMIC VISCOUS B Fusidic acid - 10mg/g 1% Drops 443,468 L.L
S01AA13 OPTIFUCIN VISCOUS G Fusidic acid - 1% 1% Drops 208,296 L.L
S01AE02 NAFLOX G Norfloxacin - 3mg/ml 3mg/ml Drops 370,901 L.L
A03AX13 OVOL B Simethicone - 40mg/ml 40mg/ml Drops 233,829 L.L
S01AE07 AROX G Moxifloxacin (HCl) - 0.5% 0.5% Drops 423,310 L.L
S01AE07 IMOX G Moxifloxacin (HCl) - 0.5% 0.5% Drops 464,970 L.L
S01BC01 INDOCOLLYRE B Indometacine - 5mg/5ml 0.1% Drops 408,528 L.L
A03CB01 RESTROPINAL PEDIATRIC B Butobarbital - 2mg/ml, Methyl hyoscine nitrate - 0.1mg/ml Drops 197,097 L.L
S01ED51 EPISOPT G Timolol - 5mg, Dorzolamide HCl - 20mg Drops 575,165 L.L
S01ED51 LOPROSTAN G Timolol - 5mg/ml, Latanoprost - 50μg/ml Drops 768,678 L.L
S01EE01 API-LOPROST G Latanoprost - 0.005% 0.005% Drops 447,500 L.L
S01EE04 TRAVONORM G Travoprost - 0.004% 0.004% Drops 564,414 L.L
S01XA18 DRYFREE G Ciclosporin - 0.05% 0.05% Drops 2,257,655 L.L
S02AA15 CETRAXAL OTICO G Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops 821,088 L.L
S02AA30 OTOCOL G Chloramphenicol - 50mg/ml, Benzocaine - 50mg/ml Drops 163,949 L.L
S02CA02 VIOCORTENE B Clioquinol - 10mg/ml, Flumetasone pivalate - 0.2mg/ml Drops 568,253 L.L
S02DA01 OTIPAX B Lidocaine HCl - 1g/100g, Phenazone - 4g/100g Drops 236,516 L.L
S03AA07 API-CIPROCIN G Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops 530,818 L.L
M02AA15 CLOFEN G Diclofenac sodium (diethylamine) - 10mg/g 1% Creamagel 210,983 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.1% Cream 215,015 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.1% Cream 215,015 L.L
D07AC01 BETNOVATE B Betamethasone (valerate) - 0.1% 0.1% w/w Cream 279,519 L.L
D07AC01 BETASONE G Betamethasone (valerate) - 1mg/g 1mg/g Cream 120,306 L.L
D07AC01 DIPROSONE B Betamethasone (dipropionate) - 0.5mg/g 0.05% Cream 291,614 L.L
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