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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
L01CD01 PANATAXEL G Paclitaxel - 150mg/25ml 150mg/25ml Injectable concentrated solution 16,521,761 L.L
L01XA03 OXALIPLATIN EBEWE G Oxaliplatin - 50mg/10ml 50mg/10ml Injectable concentrated solution 3,405,297 L.L
N05AX08 PMS-RISPERIDONE G Risperidone - 4mg 4mg Tablet 1,276,650 L.L
R05CA12 HEDERAL G Dried Ivy leaf extract - 37mg/5ml 37mg/5ml Syrup 309,084 L.L
A03FA03 PROKININ G Domperidone - 10mg 10mg Tablet, film coated 221,734 L.L
A10BB12 GLYPRIDE G Glimepiride - 3mg 3mg Tablet 571,133 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 205,933 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE D G Potassium chloride - 5.215g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 166.7g/l, Sodium chloride - 214.76g/l Injectable solution L.L
C08CA01 AMLOPHAR G Amlodipine (besylate) - 5mg 5mg Capsule 388,370 L.L
H02AB08 TRIACORT G Triamcinolone acetonide - 40mg/ml 40mg/ml Injectable suspension 745,833 L.L
J01DD15 MINOCET G Cefdinir - 300mg 300mg Capsule 1,407,003 L.L
J05AB01 LOVRAK-JULPHAR G Aciclovir - 250mg 250mg Injectable lyophilised powder 278,175 L.L
L01XA03 OXALIPLATIN HOSPIRA G Oxaliplatin - 50mg/10ml 5mg/ml Injectable concentrated solution 3,450,988 L.L
L04AX04 LEDOBOOK 15 G Lenalidomide - 15mg 15mg Capsule 62,230,245 L.L
M04AA03 STABURIC G Febuxostat - 40mg 40mg Tablet, film coated 1,081,345 L.L
N05AX08 RESPAL 4 G Risperidone - 4mg 4mg Caplet, film coated 557,695 L.L
R05CA12 LIBLAB COUGH SYRUP G Dried Ivy leaf extract - 35mg/5ml 35mg/5ml Syrup 237,860 L.L
S01XA18 DRYFREE G Ciclosporin - 0.05% 0.05% Drops 2,257,655 L.L
A10BB12 JOSWE GLEMAX 3 G Glimepiride - 3mg 3mg Caplet 506,629 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 224,565 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE E G Potassium chloride - 2.611g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 7.00g/l, Sodium acetate, 3H2O - 190.505g/l, Sodium chloride - 205.49g/l Injectable solution L.L
C08CA01 AMLORINE 5 G Amlodipine (besylate) - 5mg 5mg Tablet 388,370 L.L
C09DB04 TWINCARD 80/10 G Telmisartan - 80mg, Amlodipine - 10mg Tablet 1,460,309 L.L
G03AD02 ECINQ G Ulipristal acetate - 30mg 30mg Tablet, film coated 1,302,183 L.L
H02AB09 HYDROCORTISON VUAB G Hydrocortisone hydrogenosuccinate - 100mg 100mg Injectable dry powder for solution 147,823 L.L
J01DD15 SEFARIN G Cefdinir - 300mg 300mg Capsule 1,494,353 L.L
L01XA03 OXALIPLATIN MEDAC G Oxaliplatin - 50mg 50mg Injectable powder for solution 3,440,237 L.L
L04AX04 LENALIDOMIDE NEAPOLIS G Lenalidomide - 15mg 15mg Capsule 76,209,421 L.L
N03AG01 CONVULEX G Sodium Valproate - 50mg/ml 50mg/ml Syrup 213,671 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 4mg 4mg Tablet, coated, scored 1,105,982 L.L
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