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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
D01AE15 LAMISIL B Terbinafine HCl - 10mg/ml 1% Solution 962,191 L.L
D01AE15 LAMISIL B Terbinafine HCl - 10mg/ml 1% Solution 506,629 L.L
D01AE15 TERAFAN G Terbinafine HCl - 1% 1% Solution 355,798 L.L
D01AE22 EXODERIL B Naftifine HCl - 10mg/g 1% Cream 345,368 L.L
D01AE22 EXODERIL B Naftifine HCl - 10ml/ml 1% Solution 159,917 L.L
D11AX18 ALMIRAL G Diclofenac sodium - 1% w/w 1% w/w Gel 396,434 L.L
J01CE01 PENICILLINE G PANPHARMA G Benzylpenicillin (sodium) - 1,000,000IU 1,000,000IU Injectable powder for solution 2,858,353 L.L
J01XB01 COLIXIN G Colistimethate Sodium - 1,000,000IU 1,000,000IU Injectable powder for solution, Inhalation powder 20,296,042 L.L
B02BD02 OCTANATE BioHuman Coagulation Factor VIII - 1,000IU 1,000IU Injectable lyophilised powder for solution+diluent 46,817,511 L.L
J01DE01 CEFIPEX 1000 BENTA G Cefepime - 1,000mg 1,000mg Injectable dry powder+diluent 703,918 L.L
J01DE01 CEFIPEX 1000 BENTA G Cefepime (hydrochloride) - 1,000mg 1,000mg Injectable solution 703,918 L.L
J01CA04 OSPAMOX G Amoxicillin (trihydrate) - 1g 1,000mg Tablet, film coated 683,273 L.L
J01DB04 HIKMA CEFAZOLIN G Cefazolin (sodium) - 1g 1,000mg Injectable solution 215,015 L.L
J01DB05 BIODROXIL G Cefadroxil (monohydrate) - 1000mg 1,000mg Tablet, film coated 1,091,442 L.L
L01BC05 GEMTABINE 1000 G Gemcitabine HCl - 1,000mg 1,000mg Injectable lyophilised powder for solution L.L
A10BA02 GLUCOPHAGE B Metformin HCl - 1,000mg 1,000mg Tablet, film coated 624,963 L.L
A10BA02 DIALON G Metformin HCl - 1g 1,000mg Tablet 180,075 L.L
A10BA02 DIANORM XR 1000 G Metformin HCl - 1,000mg 1,000mg Tablet, film coated, extended release 579,772 L.L
A10BA02 DIANORM XR 1000 G Metformin HCl - 1000mg 1,000mg Tablet, film coated, extended release 579,772 L.L
N03AX14 KEPPRA B Levetiracetam - 1000mg 1,000mg Tablet, film coated 11,749,079 L.L
N03AX14 ZITERA G Levetiracetam - 1,000mg 1,000mg Tablet, film coated 3,225,222 L.L
J01DD04 MESPORIN-1000 IM G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
G01AF12 LOMEXIN "T" B Fenticonazole nitrate - 1,000mg 1,000mg Ovule 909,037 L.L
J01DD04 MESPORIN-1000 IV G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
L01AX04 DACARBAZINE MEDAC G Dacarbazine - 1,000mg 1,000mg Injectable powder for solution 5,411,654 L.L
L01BC05 GEMTABINE 1000 G Gemcitabine HCl - 1,000mg 1,000mg Injectable lyophilised powder for solution 4,882,628 L.L
L01BC01 ALEXAN G Cytarabine - 1,000mg/20ml 1,000mg/20ml Injectable solution L.L
L01BC01 ALEXAN G Cytarabine - 1,000mg/20ml 1,000mg/20ml Injectable solution 2,848,946 L.L
N06BX06 SOMAZINA B Citicoline (sodium) - 1,000mg/4ml 1,000mg/4ml Injectable solution 787,492 L.L
G03GA02 MENOPUR BioHuman Menotropin - 1,200IU 1,200IU Injectable powder for solution+diluent 27,815,659 L.L
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