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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
L04AD02 TACROGRAF 0.5 G Tacrolimus - 0.5mg 0.5mg Capsule 7,004,024 L.L
G04CA02 TALUSIN G Tamsulosin HCl - 0.4mg 0.4mg Capsule, modified release 683,440 L.L
G04CA02 TAMSU GENERICON RETARD G Tamsulosin - 0.4mg 0.4mg Capsule, hard, modified release 615,480 L.L
S01XA20 TEARS NATURALE B Duasorb - 0.4% 0.40% Drops solution 189,482 L.L
R06AD08 TOPLEXIL B Oxomemazine HCl - 0.33mg/ml 0.33mg/ml Syrup 615,480 L.L
S01AA12 TOBRACIN G Tobramycin - 0.3% 0.30% Drops 322,522 L.L
S01AA12 TOBRASTILL G Tobramycin - 0.3% 0.30% Drops solution 258,018 L.L
S01AA12 TOBRIN G Tobramycin - 0.3% 0.30% Drops 169,324 L.L
S01AA12 TOBRACIN G Tobramycin - 0.3% 0.30% Ointment 280,863 L.L
L01XK04 TALZENNA B Talazoparib - 0.25mg 0.25mg Capsule 133,836,699 L.L
D10AD01 TRETINOIN G Tretinoin - 0.1% 0.10% Solution 682,160 L.L
D11AH01 TACRUS G Tacrolimus monohydrate - 0.1% 0.10% Ointment 1,857,190 L.L
D10AD01 TRETINOIN G Tretinoin - 0.05% 0.05% Solution 623,287 L.L
R01AD09 TABUNEX G Mometasone furoate - 0.05% 0.05% Spray 419,279 L.L
D10AD01 TRETINOIN G Tretinoin - 0.025% 0.03% Solution 564,414 L.L
J07AP03 TYPHIM VI B Salmonella typhi polysaccharides - 0.025mg/0.5ml 0.025mg/0.5ml Injectable solution 1,118,077 L.L
S01EE04 TRAVATAN B Travoprost - 40mcg/ml 0.00% Drops solution 806,306 L.L
S01EE04 TRAVONORM G Travoprost - 0.004% 0.00% Drops 564,414 L.L
S01EE05 TAFLUPRO G Tafluprost - 0.0015% 0.00% Solution 1,912,288 L.L
C09BA03 TENSIKEY COMPLEX G Lisinopril - 20mg, Hydrochlorothiazide - 12.5mg Tablet 536,193 L.L
C09BA05 TRILTEC PLUS G Ramipril - 10mg, Hydrochlorothiazide - 12.5mg Tablet 2,243,577 L.L
C09BA05 TRILTEC PLUS G Ramipril - 5mg, Hydrochlorothiazide - 12.5mg Tablet 2,189,823 L.L
A02AC10 TUMS EXTRA STRENGTH 750 ASSORTED FRUIT B Calcium carbonate - 750mg Tablet, chewable 421,967 L.L
R05FA02 TUSCALMAN A B Noscapine HCl - 5mg, Guaifenesin - 25mg Suppository 624,963 L.L
J05AR03 TRUVADA B Emtricitabine - 200mg, Tenofovir disoproxil - 245mg Tablet, film coated 21,319,383 L.L
R05FA02 TUSCALMAN B B Noscapine HCl - 10mg, Guaifenesin - 50mg Suppository 615,992 L.L
J05AR12 TELADINE G Lamivudine - 300mg, Tenofovir disoproxil fumarate - 300mg Tablet 17,454,739 L.L
J05AR13 TRIUMEQ B Dolutegravir - 50mg, Abacavir sulfate - 600mg, Lamivudine - 300mg Tablet, film coated 74,756,237 L.L
R05X TRIMEDIL FORTE G O-(ß-hydroxyethyl)-rutosides - 30mg, Ascorbic acid - 80mg, Dimethindene - 0.5mg, Phenylephrine HCl - 2.5mg, Paracetamol - 200mg Capsule 386,515 L.L
C09BX01 TRIPLIXAM B Perindopril arginine - 5mg, Indapamide - 1.25mg, Amlodipine - 5mg Tablet, film coated 968,910 L.L
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