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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
A06AD04 EPSOM SALT G Magnesium sulfate - 40g 40g Granules 89,590 L.L
L02BB04 ENZASTIK 40 G Enzalutamide - 40mg 40mg Capsule 82,838,963 L.L
A02BC01 ESELAN G Omeprazole (sodium) - 40mg 40mg Injectable lyophilised powder for solution 2,073,549 L.L
C10AA05 EMITOR G Atorvastatin - 40mg 40mg Tablet, film coated 1,060,292 L.L
A02BC05 ESO TAD G Esomeprazole - 40mg 40mg Capsule, hard, gastro-resistant 389,714 L.L
A02BC05 ESOCAP-UBSA G Esomeprazole - 40mg 40mg Capsule 646,324 L.L
A02BC05 ESOFLUX G Esomeprazole - 40mg 40mg Capsule 646,324 L.L
A02BC05 ESOMEP G Esomeprazole - 40mg 40mg Tablet, gastroresistant 493,392 L.L
A02BC05 ESOMEPRAZOLE ARROW LAB G Esomeprazole - 40mg 40mg Capsule, gastro-resistant 454,219 L.L
C09CA09 EDARBI B Azilsartan medoxomil - 40mg 40mg Tablet 1,846,440 L.L
A02BC05 ESOMEPRAZOLE BIOGARAN G Esomeprazole (magnesium dihydrate) - 40mg 40mg Capsule, gastro-resistant 513,348 L.L
A02BC05 EXONAR G Esomeprazole (magnesium trihydrate) - 40mg 40mg Capsule, delayed release 639,925 L.L
A02BC05 ESAC G Esomeprazole sodium - 40mg 40mg Injectable powder for solution 430,030 L.L
A02BC05 ESOMEPRAZOLE NORMON G Esomeprazole - 40mg 40mg Injectable powder for solution 430,030 L.L
A02BC05 ESSIUM G Esomeprazole - 40mg 40mg Injectable powder for solution 314,459 L.L
L02BB04 ENZASTIK 40 G Enzalutamide - 40mg 40mg Capsule L.L
S01LA05 EYLEA BioTech Aflibercept - 40mg/ml 40mg/ml Injectable solution L.L
S01LA05 EYLEA BioTech Aflibercept - 40mg/ml 40mg/ml Injectable solution 65,161,855 L.L
N01BB54 EMLA B Prilocaine - 25mg/g, Lidocaine - 25mg/g 5% Cream 1,763,121 L.L
L01BC02 EFUDIX B Fluorouracil - 5% 5% Cream 671,921 L.L
A11CC05 EURO D HP 50.000 IU G Vitamin D3 - 50,000IU 50,000IU Capsule 1,432,536 L.L
B02BD02 ESPEROCT BioTech Turoctocog Alfa pegol (recombinant coagulation factor VIII) - 500IU/Vial 500IU/Vial Injectable powder for solution+diluent 38,126,657 L.L
J01FA09 ERACID 500 G Clarithromycin - 500mg 500mg Tablet, film coated 628,918 L.L
V03AC03 ENFEROX G Deferasirox - 500mg 500mg Tablet, dispersible 37,720,158 L.L
J01MA02 ESTECINA 500MG G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 618,168 L.L
N02BE01 EFFERALGAN B Paracetamol - 500mg 500mg Tablet, effervescent scored 129,009 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution 764,646 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution L.L
J01MA12 EVOXIL HELLAS G Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 959,504 L.L
B02AA02 EXACYL B Tranexamic acid - 500mg/5ml 500mg/5ml Injectable solution 748,520 L.L
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