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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
D06AX TRIPLE ANTIBIOTIC ORIGINAL OINTMENT Bacitracin - 400U, Neomycin (sulfate) - 3.5mg, Polymyxin B (sulfate) - 5000U 580,540 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 1000mg 12.5mg/1000mg Tablet, film coated 3,399,653 L.L
B01AE07 PRADAXA B Dabigatran etexilate (mesilate) - 150mg 150mg Capsule, hard 3,031,709 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 5mg 5mg Tablet, film coated 1,890,786 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lipocream 221,734 L.L
J01FA02 ROVAMYCINE B Spiramycin - 3MIU 3MIU Tablet, film coated 649,076 L.L
L01CX01 YONDELIS B Trabectedin - 1mg 1mg Injectable powder for solution 126,536,515 L.L
S01EE03 LUMIGAN B Bimatoprost - 0.1mg/ml 0.1mg/ml Drops solution 740,457 L.L
A01AB09 DAKTARIN ORAL B Miconazole nitrate - 20mg/g 20mg/g Gel 318,491 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 1000mg 12.5mg/1000mg Tablet, film coated 3,399,653 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lipocream 221,734 L.L
J01FA02 ROVAMYCINE B Spiramycin - 1.5MIU 1.5MIU Tablet, film coated 256,674 L.L
L04AX04 REVLIMID B Lenalidomide - 15mg 15mg Capsule 116,241,703 L.L
N02BF02 LYRICA B Pregabalin - 75mg 75mg Capsule 598,010 L.L
N06DX01 EBIXA B Memantine - 20mg 20mg Tablet, film coated 4,004,651 L.L
S01EE04 TRAVATAN B Travoprost - 40mcg/ml 0.004% Drops solution 806,306 L.L
A06AB58 PICOPREP B Magnesium oxide - 3.5g, Citric acid - 12g, Sodium picosulfate - 10mg Powder 694,767 L.L
B01AF01 XARELTO B Rivaroxaban - 2.5mg 2.5mg Tablet, film coated 4,045,168 L.L
D07AB02 LOCOID CRELO 0.1% B Hydrocortisone butyrate - 1mg/g 0.1% Emulsion 177,387 L.L
M04AA03 ADENURIC B Febuxostat - 80mg 80mg Tablet, film-scored 2,127,111 L.L
N02BF02 LYRICA B Pregabalin - 75mg 75mg Capsule 2,131,334 L.L
D07AB02 LOCOID CRELO 0.1% B Hydrocortisone butyrate - 1mg/g 0.1% Emulsion 177,387 L.L
G03GB02 CLOMID B Clomifene citrate - 50mg 50mg Tablet 274,144 L.L
N02BF02 LYRICA B Pregabalin - 75mg 75mg Capsule 598,010 L.L
N05AX08 RISPERDAL B Risperidone - 1mg/ml 1mg/ml Solution 1,377,439 L.L
L01ED05 LORBRENA B Lorlatinib - 100mg 100mg Tablet L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 850mg 12.5mg/850mg Tablet, film coated 3,287,711 L.L
B01AF01 XARELTO B Rivaroxaban - 15mg 15mg Tablet, film coated 4,440,862 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 7.5mg 7.5mg Tablet, film coated 1,890,786 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lotion 201,576 L.L
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