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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
A04AA01 TRONDAMET G Ondansetron (HCl) - 8mg/4ml 8mg/4ml Injectable solution 2,027,858 L.L
B01AC04 THROMBO G Clopidogrel - 75mg 75mg Tablet, film coated 764,646 L.L
B05BB02 SERUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 180,421 L.L
C01CA07 DOBUTAMINE PANPHARMA G Dobutamine (HCl) - 250mg/20ml 250mg/20ml Injectable concentrated solution 2,701,123 L.L
C08DB01 ZALDEM G Diltiazem HCl - 60mg 60mg Tablet, scored 199,657 L.L
C09DX01 VIOSTAN AM PLUS 320/10/25 G Valsartan - 320mg, Amlodipine - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,881,380 L.L
G03DA04 PROGEST 200 G Progesterone micronised - 200mg 200mg Capsule, soft gelatin 411,216 L.L
J01DH02 AROPEM G Meropenem (trihydrate) - 0.5g 0.5g Injectable powder for solution 995,723 L.L
J05AB01 ACTI-VIR G Aciclovir - 200mg 200mg Tablet, scored 1,039,238 L.L
L01CD01 PANATAXEL G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrated solution 16,521,761 L.L
L01XA02 KARBOTEEN G Carboplatin - 150mg/15ml 150mg/15ml Injectable solution 2,080,268 L.L
L04AX04 LENALIDOMIDE ARROW G Lenalidomide - 5mg 5mg Capsule 26,651,802 L.L
M04AA01 APO-ALLOPURINOL G Allopurinol - 300mg 300mg Tablet 626,231 L.L
N06DX01 MEMANTINE BIOGARAN G Memantine HCl - 20mg 20mg Tablet, coated 2,444,450 L.L
R05 COQUELUSEDAL ENFANT G Grindelia extract - 20mg, Gelsenium extract - 10mg Suppository 598,051 L.L
A04AA01 α ONDANSETRON USP G Ondansetron - 8mg/4ml 8mg/4ml Injectable solution 447,948 L.L
B01AC04 TROKEN G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 1,148,985 L.L
B05BB02 SOLUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 236,731 L.L
C01CA24 ADRENALINE 1 MG I.V. G Adrenaline - 1mg/ml 1mg/ml Injectable solution 2,239,738 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 180mg 180mg Capsule, controlled release 966,287 L.L
D05AX52 BETA-CAL G Calcipotriol (monohydrate) - 50mcg/g, Betamethasone (dipropionate) - 0.5mg/g Gel 1,251,117 L.L
J01DH02 AROPEM G Meropenem - 0.5g 0.5g Injectable powder for solution 995,723 L.L
J05AB01 CYCLOVEX G Aciclovir - 200mg 200mg Tablet, scored 1,164,664 L.L
L01XA02 CARBOPLATINE VIATRIS 10MG/ML G Carboplatin - 50mg/5ml 50mg/5ml Injectable solution 941,930 L.L
L04AX04 LENALIDOMIDE NEAPOLIS G Lenalidomide - 5mg 5mg Capsule 68,908,116 L.L
M04AA01 ALLOPURINOL BIOGARAN G Allopurinol - 200mg 200mg Tablet 169,324 L.L
N05AX08 PMS-RISPERIDONE G Risperidone - 1mg 1mg Tablet 823,775 L.L
N06DX01 MEMORA G Memantine HCl - 20mg 20mg Tablet, film coated 1,593,413 L.L
R05C PULMONAL SIROP G Belladona tincture - 0.5g/5ml, Drosera tincture - 2g/5ml, Ammonium bromide - 2g/5ml, Sodium benzoate - 2g/5ml Syrup 148,463 L.L
S01GA52 TRILLERG G Antazoline HCl - 0.5mg, Tetryzoline HCl - 0.4mg Drops solution 310,428 L.L
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