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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
C02KX01 TRACLEER B Bosentan (monohydrate) - 62.5mg 62.5mg Tablet, film coated 79,583,961 L.L
J02AC02 TRACON G Itraconazole - 100mg 100mg Capsule 559,038 L.L
C02KX01 TRACTAN G Bosentan (monohydrate) - 125mg 125mg Tablet, film coated 47,747,570 L.L
C02KX01 TRACTAN G Bosentan (monohydrate) - 62.5mg 62.5mg Tablet, film coated 47,747,570 L.L
G02CX01 TRACTOCILE B Atosiban acetate - 7.5mg/ml 7.5mg/ml Injectable solution 2,592,272 L.L
G02CX01 TRACTOCILE B Atosiban acetate - 7.5mg/ml 7.5mg/ml Injectable solution 8,282,804 L.L
A10BH05 TRAJENTA B Linagliptin - 5mg 5mg Tablet, film coated 3,213,127 L.L
N02AX02 TRAMADOL ARROW G Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 318,491 L.L
N02AX02 TRAMADOL DENK 50 G Tramadol HCl - 50mg 50mg Tablet, effervescent 256,674 L.L
N02AX02 TRAMADOL NORMON G Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 169,324 L.L
N02AJ13 TRAMADOL/PARACETAMOL ARROW LAB G Tramadol - 37.5mg, Paracetamol - 325mg Tablet, coated 205,608 L.L
N02AX02 TRAMAL B Tramadol HCl - 50mg 50mg Capsule 349,399 L.L
N02AX02 TRAMAL 100MG B Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 243,235 L.L
N02AX02 TRAMAL RAPIDE B Tramadol HCl - 50mg 50mg Tablet 388,370 L.L
N02AX02 TRAMAL RETARD B Tramadol HCl - 100mg 100mg Tablet, modified release 236,516 L.L
N02AX02 TRAMAL RETARD B Tramadol HCl - 150mg 150mg Tablet, modified release 356,118 L.L
N02AX02 TRAMAL RETARD B Tramadol HCl - 200mg 200mg Tablet, modified release 474,376 L.L
M03BB52 TRANCODEX G Paracetamol - 450mg, Chlormezanone - 100mg Tablet 99,828 L.L
N05BA12 TRANQUINAL 0.5 G Alprazolam - 0.5mg 0.5mg Tablet 267,425 L.L
N05BA12 TRANQUINAL 0.5 SUBLINGUAL G Alprazolam - 0.5mg 0.5mg Tablet, sublingual 459,594 L.L
L01FD01 TRASTUREL BioTech Trastuzumab - 440mg 440mg Injectable lyophilised powder L.L
L01FD01 TRASTUREL BioTech Trastuzumab - 440mg 440mg Injectable lyophilised powder 52,047,114 L.L
M01AB05 TRATUL G Diclofenac Deanol - 90mg 90mg Injectable solution 490,503 L.L
M01AB05 TRATUL RETARD G Diclofenac Sodium - 100mg 100mg Tablet, film coated 866,778 L.L
N06BX06 TRAUSAN G Citicoline - 100mg/ml 100mg/ml Drops solution 807,649 L.L
S01EE04 TRAVATAN B Travoprost - 40mcg/ml 0.004% Drops solution 806,306 L.L
J01DD04 TRAVILAN IM G Ceftriaxone (sodium) - 1g 1g Injectable lyophilised powder for solution+diluent 438,093 L.L
D07XC04 TRAVOCORT B Diflucortolone valerate - 0.1%, Isoconazole nitrate - 1% Cream 435,405 L.L
S01EE04 TRAVONORM G Travoprost - 0.004% 0.004% Drops 564,414 L.L
S01EE04 TRAVOPROST BIOGARAN G Travoprost - 40mcg/ml 40mcg/ml Drops solution 564,414 L.L
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