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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
B05BB02 5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 153,990 L.L
C01CA03 EPINORD G Noradrenaline (tartrate) - 8mg/4ml 8mg/4ml Injectable solution 2,751,678 L.L
C08CA05 NIFELAT 60 LA G Nifedipine - 60mg 60mg Tablet, prolonged release 1,290,089 L.L
C09DX01 VIOSTAN AM PLUS 160/5/25 G Valsartan - 160mg, Amlodipine - 5mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,196,020 L.L
D04AB01 PROCOMIL G Lidocaine - 10% 10% Spray 139,760 L.L
G03CA03 MONTADIOL G Estradiol - 0.01% 0.01% Cream 1,105,982 L.L
J01DD15 XEVANEER G Cefdinir - 300mg 300mg Capsule 1,350,562 L.L
J02AX04 CANDIGARD G Caspofungin (acetate) - 50mg 50mg Injectable powder for concentrate for solution 22,127,179 L.L
L01CD01 PATAXEL G Paclitaxel - 300mg/50ml 300mg/50ml Injectable concentrate for solution 17,809,220 L.L
N05AH04 SEROPINE XR 300 G Quetiapine fumarate - 300mg 300mg Tablet, extended release 4,744,660 L.L
N06DA52 EXENTAZIL G Donepezil - 10mg, Memantine - 28mg Capsule 4,363,009 L.L
R03DC03 ROMILAST G Montelukast (sodium) - 4mg 4mg Tablet, mouth dissolving 405,840 L.L
A04AA01 ONDANSETRON MEDIS G Ondansetron - 4mg/2ml 4mg/2ml Injectable solution 978,317 L.L
B01AC04 CLOPI TAD G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 911,125 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 205,933 L.L
C01CA03 NORADRENALINE NOREPINEPHRINE (tartrate) Aguettant G Norepinephrine tartrate - 2mg/ml 2mg/ml Injectable solution 1,896,162 L.L
C08CA05 NIFE-PAR G Nifedipine - 5mg/ml 5mg/ml Solution 38,120,008 L.L
J02AX04 CASPOFUNGINE STRAGEN G Caspofungin (acetate) - 50mg 50mg Injectable concentrated powder for solution 18,712,833 L.L
L01CD01 EBETAXEL G Paclitaxel - 30mg/5ml 30mg/5ml Injectable concentrated solution 2,983,330 L.L
N02BE71 PYRETHAL G Paracetamol - 200mg, Phenobarbital - 20mg Suppository 147,183 L.L
N05AH04 QUETIAPINE BIOGARAN L.P. G Quetiapine fumarate - 50mg 50mg Tablet, prolonged release 1,010,570 L.L
N06DA52 MEXAZIL XR 28/10 G Memantine HCl - 28mg, Donepezil HCl - 10mg Capsule 4,333,444 L.L
R03DC03 UNICAST G Montelukast (sodium) - 4mg 4mg Tablet, chewable 783,460 L.L
S01EE04 TRAVONORM G Travoprost - 0.004% 0.004% Drops 564,414 L.L
A04AA01 ONDANSETRON RENAUDIN G Ondansetron (HCl dihydrate) - 4mg/2ml 4mg/2ml Injectable solution 1,791,342 L.L
A10BD02 ORBIZIDE M FORTE G Metformin HCl - 500mg, Gliclazide - 80mg Tablet 771,750 L.L
B01AC04 CLOPIDOGREL ARROW G Clopidogrel besylate - 75mg 75mg Tablet, film coated 658,483 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 182,720 L.L
C01CA03 NORADRENALINE NOREPINEPHRINE (tartrate) Aguettant G Norepinephrine tartrate - 2mg/ml 2mg/ml Injectable solution 1,896,162 L.L
C09DX01 LOTEVAN PLUS G Valsartan - 160mg, Amlodipine - 10mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 911,125 L.L
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