Overview
UNHCR’s public health approach is based on primary health care (PHC) strategy. Secondary and tertiary health care institutions in Lebanon are mostly private and cost is a significant barrier to access. To harmonize access to secondary healthcare and manage costs, UNHCR has put in place referral guidelines and standard operating procedures (SOP) to support access to life saving and obstetric care. The costs covered by UNHCR vary according to the type of service provided and the vulnerability status of the refugee.
UNHCR contracts a third party administrator (TPA) to manage the referral care system. In March 2015, a new TPA took over the administration of the referral care system.
At the end of 2015, 1,055,984 Syrian refugees and 21,348 refugees from Iraq, Sudan and Somalia were covered under the UNHCR referral health care programme.
The number of referral request covered financially by UNHCR increased from 89% in 2014 to 95% in 2015.
The majority (70%) of accepted referrals were covered in the 20 receiving hospitals.
The majority (56.9%) of referrals were for maternity care, 34% of deliveries were by C-section compared to 36% in 2014.
There were 652 deaths of which 61% were in children under one year of age, predominantly in the perinatal period.
There was a 12% deduction of the total charged cost by hospitals at TPA financial audit.
40% of total expenditure was on maternity care.
The average cost per referral was 544 USD compared to 489 USD in 2014
Annual cost of referral care per capita was 26.6 USD compared to 33.4 USD in 2014.
Data
UNHCR, through its TPA, collected data on requests for hospital referral coverage. The data for accepted referrals included the type of admission, type of service received, diagnosis on discharge and cost of the service.