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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
C05BA53 CONTRACTUBEX B Allantoin - 1g/100g, Cepae - 10g/100g, Heparin - 5,000IU/100g Gel 1,183,925 L.L
R06AX CYPRO-BC B Cyproheptadine HCl - 2mg/5ml, Vitamin B3 - 5mg/5ml, Vitamin B6 - 0.60mg/5ml, Vitamin B2 - 0.75mg/5ml, Vitamin B1 - 0.60mg/5ml, Vitamin C - 20mg/5ml Syrup 449,227 L.L
C10AA07 CRESTOR B Rosuvastatin (calcium) - 20mg 20mg Tablet, film coated 804,962 L.L
R06AX13 CLARITINE B Loratadine (micronised) - 10mg 10mg Tablet 219,046 L.L
R06AX13 CLARITINE B Loratadine (micronised) - 10mg 10mg Tablet 618,168 L.L
A09AA02 CREON 10,000 B Pancreatin protease - 600FIP-U, Pancreatin amylase - 8,000FIP-U, Pancreatin lipase - 10,000FIP-U Capsule 1,835,689 L.L
A09AA02 CREON 25,000 B Pancreatin protease - 1000FIP-U, Pancreatin amylase - 18000FIP-U, Pancreatin lipase - 25000FIP-U Capsule 4,598,629 L.L
R06AX13 CLARITINE B Loratadine (micronised) - 5mg/5ml 5mg/5ml Syrup 430,030 L.L
L01DB01 CAELYX B Doxorubicin HCl pegylated liposomes - 20mg/10ml 20mg/10ml Injectable concentrated solution L.L
C10AA07 CRESTOR B Rosuvastatin (calcium) - 40mg 40mg Tablet, film coated 804,962 L.L
L04AA06 CELLCEPT B Mycophenolate mofetil - 250mg 250mg Capsule 6,083,575 L.L
N06AB10 CIPRALEX B Escitalopram (oxalate) - 10mg 10mg Tablet, film coated 1,548,107 L.L
L04AA06 CELLCEPT B Mycophenolate mofetil - 500mg 500mg Tablet 6,083,575 L.L
C10AA07 CRESTOR B Rosuvastatin (calcium) - 5mg 5mg Tablet 589,947 L.L
J01DC04 CECLOR B Cefaclor (monohydrate) - 250mg/5ml 250mg/5ml Granules for suspension 851,100 L.L
L01EL02 CALQUENCE B Acalabrutinib - 100mg 100mg Tablet, film coated 650,653,454 L.L
J01DC04 CECLOR MR B Cefaclor (monohydrate) - 500mg 500mg Tablet, film coated, modified release 1,226,096 L.L
J01DC04 CECLOR MR B Cefaclor (monohydrate) - 750mg 750mg Tablet, film coated, modified release 1,555,018 L.L
N06AB10 CIPRALEX B Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 2,378,601 L.L
J01DC04 CECLOR B Cefaclor (monohydrate) - 125mg/5ml 125mg/5ml Granules for suspension 487,623 L.L
L04AA18 CERTICAN B Everolimus - 0.5mg 0.5mg Tablet 26,832,962 L.L
L04AA18 CERTICAN B Everolimus - 0.75mg 0.75mg Tablet 26,832,962 L.L
L04AA18 CERTICAN B Everolimus - 0.5mg 0.5mg Tablet L.L
L04AA18 CERTICAN B Everolimus - 0.75mg 0.75mg Tablet L.L
C09DA03 CO-DIOVAN B Valsartan - 80mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 602,041 L.L
C09DA03 CO-DIOVAN B Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 846,621 L.L
C07AB07 CONCOR B Bisoprolol fumarate - 5mg 5mg Tablet, film coated 870,164 L.L
L01EX07 CABOMETYX B Cabozantinib - 20mg 20mg Tablet, film coated 440,893,501 L.L
L01EX07 CABOMETYX B Cabozantinib - 40mg 40mg Tablet, film coated 440,893,501 L.L
M01AH01 CELEBREX B Celecoxib - 200mg 200mg Capsule 1,126,140 L.L
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