Abstract

The Syrian refugee influx in Lebanon challenges non-communicable disease (NCD) management, requiring evidence to adapt intervention to quality care demands. Baseline data from a longitudinal cohort study examines general practitioner (GP) and specialist care-seeking by Syrian refugee and Lebanese patients with hypertension and/or diabetes at ten Lebanese primary health facilities. Negative binomial hurdle regression models separately evaluate the odds and frequency of care-seeking by each condition and provider type. Utilization was uniformly high in both populations. Refugees were more likely to seek GP care and had higher GP visit frequency; Lebanese relied more on specialists’ care. Multivariate analyses revealed notable associations between housing instability and reduced odds and volume of specialist care for both conditions and with lower odds of GP care-seeking for diabetes. Patient YMCA medication program enrollment was also associated with fewer GP visits for both conditions, although increased odds of specialist care for diabetes. Patient and provider focus groups highlighted factors motivating care utilization (primarily cost and obtaining medication), limited specialist availability, and GP self-doubt concerning effective treatment. Expanded GP training and improving and scaling the YMCA program could further efforts for improved NCD management quality and health outcomes.