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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
C02AB02 ALDOMET B Methyldopa - 250mg 250mg Tablet, coated 644,400 L.L
C09BA03 ZESTORETIC B Lisinopril (dihydrate) - 20mg, Hydrochlorothiazide - 12.5mg Tablet 663,858 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.10% Cream 215,015 L.L
G03GB02 CLOMID B Clomifene citrate - 50mg 50mg Tablet 274,144 L.L
J05AH02 TAMIFLU B Oseltamivir (phosphate) - 75mg 75mg Capsule 1,464,788 L.L
L01XX24 ONCASPAR B Pegaspargase - 750U/ml 750U/ml Injectable powder for solution 172,758,585 L.L
N03AE01 RIVOTRIL B Clonazepam - 0.5mg 0.5mg Tablet, scored 403,153 L.L
N05AX13 INVEGA B Paliperidone - 9mg 9mg Tablet, extended release 5,825,557 L.L
R05DB13 SINECOD B Butamirate dihydrogenocitrate - 15mg/10ml 15mg/10ml Syrup, sugar free 521,411 L.L
V01AA STALORAL B Allergen extracts - 2 x 100IR ou IC/ml Solution 8,449,319 L.L
A01AB09 DAKTARIN ORAL B Miconazole nitrate - 20mg/g 20mg/g Gel 377,620 L.L
C02AB02 ALDOMET B Methyldopa - 500mg 500mg Tablet, coated 856,708 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.10% Cream 215,015 L.L
M05BA08 ACLASTA B Zoledronic acid (monohydrate) - 5mg/100ml 5mg/100ml Injectable solution 21,075,062 L.L
N03AE01 RIVOTRIL B Clonazepam - 2mg 2mg Tablet, scored 503,941 L.L
N05AX13 INVEGA B Paliperidone - 3mg 3mg Tablet, extended release 5,386,121 L.L
V01AA STALORAL B Allergen extracts - 300 IR ou IC/ml Solution 6,598,267 L.L
A06AD11 DUPHALAC B Lactulose - 6.7g/10ml 6.7g/10ml Solution 454,219 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 850mg 12.5mg/850mg Tablet, film coated 3,287,711 L.L
C02AC05 CYNT B Moxonidine - 0.2mg 0.2mg Tablet, film coated 937,444 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 5mg, Indapamide - 1.25mg Tablet, film coated 452,875 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.10% Lipocream 221,734 L.L
L01XX41 HALAVEN B Eribulin mesylate - 0.88mg/2ml 0.88mg/2ml Injectable solution 35,421,768 L.L
N05AX13 INVEGA B Paliperidone - 6mg 6mg Tablet, extended release 5,825,557 L.L
V01AA STALORAL B Allergen extracts - 10-100-100 IR ou IC/ml 10-100-100 IR ou IC/ml Solution 9,129,688 L.L
A10BD20 SYNJARDY B Empagliflozin - 5mg, Metformin HCl - 850mg 5mg/850mg Tablet, film coated 3,287,711 L.L
B01AF01 XARELTO B Rivaroxaban - 20mg 20mg Tablet, film coated 4,440,862 L.L
C02AC05 CYNT B Moxonidine - 0.3mg 0.3mg Tablet, film coated 1,266,372 L.L
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
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