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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
B01AC06 ASPI-COR G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 690,735 L.L
B05BB02 2.5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 2.5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 224,090 L.L
C01CA24 ADRENALINE AGUETTANT G Adrenaline - 0.1mg/ml 0.1mg/ml Injectable solution 13,990,891 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 10mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,067,011 L.L
J05AB01 VICLORIX 800 G Aciclovir - 800mg 800mg Tablet 4,321,797 L.L
L01CD02 DOCETAXEL ACCORD G Docetaxel - 80mg/4ml 80mg/4ml Injectable concentrate for solution 15,099,641 L.L
L01XA03 OXALIPLATINE VIATRIS 5MG/ML G Oxaliplatin - 100mg 100mg Injectable powder for solution 6,976,204 L.L
L04AX04 LENOMA G Lenalidomide - 5mg 5mg Capsule, hard 68,908,116 L.L
M04AA03 FEBUXOSTAT BIOGARAN G Febuxostat - 120mg 120mg Tablet, film coated 1,402,972 L.L
N02BF02 NERVAX G Pregabalin - 75mg 75mg Capsule 513,348 L.L
R05CA03 MUCINEX G Guaifenesin - 600mg 600mg Tablet, extended release 749,864 L.L
S01GX08 ZALERG G Ketotifen - 0.25mg/ml 0.25mg/ml Drops solution 446,156 L.L
L01EA01 GLIMATINIB BENTA 400 G Imatinib (mesylate) - 400mg 400mg Tablet, film coated L.L
A04AA01 ZONETRON ODT G Ondansetron - 8mg 8mg Tablet, orodispersible 998,283 L.L
B01AC06 ASPICOT G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 353,239 L.L
B05BB02 2.5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 2.5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 150,543 L.L
C01CA26 EPHEDRINE AGUETTANT G Ephedrine HCl - 30mg/ml 30mg/ml Injectable solution 614,136 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 240mg 240mg Capsule, controlled release 1,002,123 L.L
J01DH02 ARCHIFAR G Meropenem - 1g 1g Injectable powder for solution 6,443,725 L.L
L01CD02 DOCETAXEL EBEWE G Docetaxel - 80mg/8ml 80mg/8ml Injectable solution 19,518,281 L.L
L01XA03 OXALIPLATINO GP PHARM G Oxaliplatin - 100mg 100mg Injectable lyophilised powder for solution 6,197,802 L.L
L04AX04 SOTIRA G Lenalidomide - 5mg 5mg Capsule 68,908,116 L.L
M04AA03 OXUBAT 120 G Febuxostat - 120mg 120mg Tablet, film coated 1,549,002 L.L
N02BF02 NEUREXAL G Pregabalin - 75mg 75mg Capsule 335,577 L.L
N07AX01 JAMP PILOCARPINE G Pilocarpine HCl - 5mg 5mg Tablet 3,668,690 L.L
R05CA12 HEDERAL G Dried Ivy leaf extract (Hedera Helix) - 99mg/5ml 99mg/5ml Drops solution 384,339 L.L
S01GX08 BRUNISTILL G Ketotifen - 250mcg/ml 250mcg/ml Drops solution 940,690 L.L
A04AA01 NAUSETRON G Ondansetron - 4mg/5ml 4mg/5ml Solution 958,608 L.L
A10BD07 SAGIMET G Metformin HCl - 850mg, Sitagliptin (HCl monohydrate) - 50mg Tablet, film coated 1,463,892 L.L
B01AC06 ASPROTHIN G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 148,463 L.L
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