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r UNWRA because patients managed to accommodate the increase by changing their hospital preference The study is limited in that it cannot argue causality between the policy and the results found because there is no control group. Nevertheless, robustness testing, including assessing the year 2017, supports our results. This study contributes to the literature on the impacts of co-payments in health care in a very specific context of poverty and conflict that has rarely been subject to scrutiny and provides feedbac