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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
A03CA02 LIBROCOL G Chlordiazepoxide - 5mg, Clidinium bromide - 2.5mg Tablet 338,648 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 218,681 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.02g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 239,275 L.L
D01AE15 LAMIFEN G Terbinafine HCl - 1% 1% Cream 350,743 L.L
M02AA15 LOCAGEL G Diclofenac sodium (diethylamine) - 10mg/g 10mg/g Gel 223,078 L.L
B05BB01 LACTATED RINGER'S INJECTION USP G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.6g/100ml Injectable solution 197,659 L.L
D01AE15 LAMINOX G Terbinafine HCl - 10mg/g 10mg/g Cream 453,067 L.L
A10BB09 LOWZID XR G Gliclazide - 60mg 60mg Tablet, extended release 309,724 L.L
B05BB01 LACTATED RINGER'S INJECTION USP G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.6g/100ml Injectable solution 209,151 L.L
S01CA01 LEVIOSA G Levofloxacin - 5mg/ml, Dexamethasone - 1mg/ml Drops solution 1,427,161 L.L
B05BB01 LACTATED RINGER'S INJECTION, USP G Sodium lactate - 3.1g/l, Calcium chloride, 2H2O - 0.2g/l, Potassium chloride - 0.3g/l, Sodium chloride - 6g/l Injectable solution 216,046 L.L
S01CA02 LOXTRA G Prednisolone acetate - 2mg/ml, Tetrahydrozoline HCl - 0.4mg/ml, Ofloxacin - 3mg/ml Drops suspension 423,310 L.L
B05BB01 LR G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 218,681 L.L
C09DB01 LOTEVAN G Amlodipine - 5mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
H02AB04 LISAMETHYLE G Methylprednisolone sodium succinate - 40mg/2ml 40mg/2ml Injectable powder for solution+diluent 7,905,545 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 234,862 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 268,908 L.L
B05BB01 LACTATED RINGER'S INJECTION, USP G Sodium lactate - 3.1g/l, Calcium chloride, 2H2O - 0.2g/l, Potassium chloride - 0.3g/l, Sodium chloride - 6g/l Injectable solution 232,134 L.L
B05BB01 LR G Sodium lactate - 0.3g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 234,862 L.L
C09DB01 LOTEVAN G Amlodipine - 10mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
D01BA02 LAMIFEN G Terbinafine HCl - 250mg 250mg Tablet 245,923 L.L
D01BA02 LAMINOX G Terbinafine HCl - 250mg 250mg Tablet 725,675 L.L
R03DC03 LUKAST G Montelukast (sodium) - 5mg 5mg Tablet, chewable 783,460 L.L
C08CA01 LOTENSE G Amlodipine (besylate) - 5mg 5mg Capsule 388,370 L.L
C08CA01 LOWRAC 5 G Amlodipine (besylate) - 5mg 5mg Capsule 362,837 L.L
C08CA01 LUSTRA G Amlodipine - 5mg 5mg Tablet 485,127 L.L
R03DC03 LEUKOTRIS G Montelukast - 10mg 10mg Tablet 981,645 L.L
C09DB06 LOSANET AM G Losartan potassium - 100mg, Amlodipine - 10mg Tablet 1,044,358 L.L
R03DC03 LUKAST G Montelukast (sodium) - 10mg 10mg Tablet, film coated 802,274 L.L
C09DB06 LOSANET AM G Losartan potassium - 100mg, Amlodipine - 5mg Tablet 1,044,358 L.L
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