Health service utilization and adherence to medication for hypertension and diabetes among Syrian refugees and affected host communities in Lebanon

Lyles, Emily; Burnham, Gilbert; Chlela, Lara; Spiegel, Paul; Morlock, Laura; Doocy, Shannon

METHODS: This study uses data from a 2015 household survey of Syrian refugees and Lebanese host communities. A total of 1,376 refugee and 686 host community households were surveyed using a cluster design with probability proportional to size sampling. Differences in outcomes of interest by population group were examined using Pearson’s chi-square and t-test methods and the crude and adjusted odds of care-seeking and interrupted medication adherence among Syrian refugees were estimated using logistic regression. RESULTS: Findings identified significant gaps between refugees and host community members in care-seeking, health facility utilization, out-of-pocket payments for care, and medication interruption. While host community members had better access to care and fewer reports of medication interruption compared to refugees, out-of-pocket spending for the most recent care visit was significantly higher among host community care-seekers. Refugee care-seekers most frequently received care at primary health facilities, choosing to do so mainly for reasons related to cost, whereas host community care-seekers predominantly utilized private clinics with greater concern for quality and continuity of care. CONCLUSION: Further efforts are needed to facilitate lower and more predictable health service costs for refugees and vulnerable host community members, as is continued communication on available subsidized care. PURPOSE: To characterize care-seeking, health service utilization and spending, and medication prescribing and adherence for hypertension and diabetes among Syrian refugees and host communities in Lebanon. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s40200-020-00638-6) contains supplementary material, which is available to authorized users.