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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) - 125mg 125mg Tablet, film coated 79,583,961 L.L
C09BB04 COVERAM B Perindopril arginine - 5mg, Amlodipine - 5mg Tablet 821,088 L.L
D07AC01 BETNOVATE B Betamethasone (valerate) - 0.1% 0.1% w/w Cream 279,519 L.L
G04BD06 MICTONORM B Propiverine HCl - 15mg 15mg Tablet, coated 1,261,868 L.L
J01FA09 KLACID RM B Clarithromycin - 500mg 500mg Tablet, modified release 1,173,175 L.L
L01XX74 WELIREG B Belzutifan - 40mg 40mg Tablet, film coated 1,550,772,301 L.L
N03AG01 DEPAKINE B Sodium Valproate - 200mg/ml 200mg/ml Solution 360,150 L.L
N05AX13 TREVICTA B Paliperidone - 350mg 350mg Injectable suspension, prolonged release 50,113,800 L.L
V03AB14 PROSULF 1% B Protamine sulfate - 50mg/5ml 1% Injectable solution 8,216,459 L.L
A02AF02 MAALOX PLUS B Simethicone - 25mg/5ml, Aluminium hydroxide - 175mg/5ml, Magnesium hydroxide - 200mg/5ml Suspension 438,093 L.L
C02KX01 TRACLEER B Bosentan (monohydrate) - 125mg 125mg Tablet, film coated 79,583,961 L.L
G04BD06 MICTONORM XL B Propiverine HCl - 30mg 30mg Capsule, modified release 1,648,895 L.L
M09AX01 HYALGAN B Hyaluronic acid (sodium) - 20mg/2ml 20mg/2ml Injectable solution 3,407,985 L.L
N03AG01 DEPAKINE B Sodium Valproate - 500mg 500mg Tablet, enteric coated 479,752 L.L
N05AX13 TREVICTA B Paliperidone - 525mg 525mg Injectable suspension, prolonged release 75,169,378 L.L
V03AB35 BRIDION B Sugammadex - 200mg/2ml 100mg/ml Injectable solution 54,230,830 L.L
A10BG03 ACTOS B Pioglitazone HCl - 15mg 15mg Tablet 1,243,054 L.L
D07AC01 DIPROSONE B Betamethasone (dipropionate) - 0.5mg/g 0.05% Cream 291,614 L.L
G04BD06 MICTONORM XL B Propiverine HCl - 45mg 45mg Capsule, modified release 1,877,348 L.L
M09AX10 EVRYSDI B Risdiplam - 0.75mg/ml 0.75mg/ml Powder 865,644,067 L.L
N05AX13 BYANNLI B Paliperidone - 1000mg 1000mg Injectable suspension, prolonged release 141,224,257 L.L
C09BB04 COVERAM B Perindopril arginine - 10mg, Amlodipine - 5mg Tablet 1,116,733 L.L
D07AC01 BETNOVATE B Betamethasone (valerate) - 0.1% 0.1% w/w Ointment 279,519 L.L
G04BD06 MICTONORM B Propiverine HCl - 5mg 5mg Tablet, coated 1,917,663 L.L
L02AE03 ZOLADEX DEPOT B Goserelin (acetate) - 3.6mg 3.6mg Injectable suspension 8,820,074 L.L
N03AG01 DEPAKINE B Sodium Valproate - 200mg 200mg Tablet, enteric coated 240,548 L.L
N05AX13 BYANNLI B Paliperidone - 700mg 700mg Injectable suspension, prolonged release 96,913,176 L.L
G04BD07 DETRUSITOL B Tolterodine (tartrate) - 2mg 2mg Tablet, film coated 1,995,606 L.L
J05AR13 TRIUMEQ B Dolutegravir - 50mg, Abacavir sulfate - 600mg, Lamivudine - 300mg Tablet, film coated 74,756,237 L.L
L02AE03 ZOLADEX LA B Goserelin (acetate) - 10.8mg 10.8mg Injectable suspension 35,121,328 L.L
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