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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
R02A ALFA-AMYLASE BGR CONSEIL G Alpha-Amylase - 3,000U.CEIP 3,000U.CEIP Tablet, coated 290,270 L.L
N01BB03 MEDICAINE 3% SANS VASOCONSTRICTEUR G Mepivacaine HCl - 3% 3% Injectable solution 954,128 L.L
N01BB03 SCANDINIBSA G Mepivacaine HCl - 3% 3% Injectable solution 1,191,988 L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 3% 3% Injectable solution 2,576,146 L.L
N02BE01 EFFERALGAN B Paracetamol - 3% 3% Solution 163,949 L.L
D06AA04 MEPHICYCLINE DERMIQUE G Tetracycline HCl - 3% 3% Ointment 145,903 L.L
D06AA04 TETRACYCLINE OINTMENT G Tetracycline HCl - 3% 3% Ointment 107,507 L.L
C01CA26 EPHEDRINE RENAUDIN G Ephedrine HCl - 30mg/ml 3% Injectable solution 693,423 L.L
L01BB04 LITAK 10 B Cladribine - 2mg/ml 2mg/ml Injectable solution 124,768,660 L.L
J01XX08 LINEZOLID ARROW G Linezolide - 600mg/300ml 2mg/ml Injectable solution 13,282,147 L.L
J02AC01 STABILANOL G Fluconazole - 2mg/ml 2mg/ml Injectable solution 1,242,583 L.L
C01CA03 NORADRENALINE NOREPINEPHRINE (tartrate) Aguettant G Norepinephrine tartrate - 2mg/ml 2mg/ml Injectable solution 1,896,162 L.L
C01CA03 NORADRENALINE NOREPINEPHRINE (tartrate) Aguettant G Norepinephrine tartrate - 2mg/ml 2mg/ml Injectable solution 1,896,162 L.L
R03AC02 ASMALAT G Salbutamol (sulfate) - 2mg/5ml 2mg/5ml Syrup 177,899 L.L
R03AC02 BUTALIN G Salbutamol (sulfate) - 2mg/5ml 2mg/5ml Syrup, sugar free 122,290 L.L
N04BC09 NEUPRO B Rotigotine - 2mg/24h 2mg/24h Patch 4,427,961 L.L
B02BA01 KONAKION MM PEDIATRIC B Phytomenadione - 2mg/0.2ml 2mg/0.2ml Solution 442,124 L.L
B02BD08 NOVOSEVEN RT BioTech Eptacog alfa (activated) recombinant - 2mg 2mg (100KIU) Injectable powder for solution+diluent 105,957,406 L.L
G04BD07 DETRUSITOL B Tolterodine (tartrate) - 2mg 2mg Tablet, film coated 1,995,606 L.L
G04BD07 TOREDA G Tolterodine (tartrate) - 2mg 2mg Tablet, film coated 2,311,409 L.L
A06AX05 RESOLOR B Prucalopride succinate - 2mg 2mg Tablet, film coated 5,251,736 L.L
A06AX05 CONSTIPRIDE G Prucalopride succinate - 2mg 2mg Tablet, film coated 2,956,454 L.L
A07DA03 IMODIUM B Loperamide HCl - 2mg 2mg Capsule 138,416 L.L
A07DA03 LOPERAMIDE ARROW LAB G Loperamide HCl - 2mg 2mg Capsule 442,124 L.L
A07DA03 IMODIUM INSTANTS B Loperamide HCl - 2mg 2mg Tablet, orodispersible 451,531 L.L
A10BX02 NOVONORM B Repaglinide - 2mg 2mg Tablet 666,546 L.L
A10BX02 REPAGLINIDE ARROW LAB G Repaglinide - 2mg 2mg Tablet 831,839 L.L
N03AX22 FYCOMPA B Perampanel - 2mg 2mg Tablet, film coated 1,138,235 L.L
R03AC02 SALBUTAMOL SULFATE G Salbutamol (sulfate) - 2mg 2mg Tablet, scored 401,873 L.L
L04AA37 OLUMIANT B Baricitinib - 2mg 2mg Tablet, film coated 68,053,864 L.L
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