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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
C09BB04 COVERAM B Perindopril arginine - 5mg, Amlodipine - 5mg Tablet 821,088 L.L
C09BB04 COVERAM B Perindopril arginine - 10mg, Amlodipine - 5mg Tablet 1,116,733 L.L
R06AD52 CODOPALM G Promethazine HCl - 5mg/5ml, Sodium gentisate - 0.5mg/5ml Syrup 149,742 L.L
C09BB04 COVERAM B Perindopril arginine - 10mg, Amlodipine - 10mg Tablet 1,116,733 L.L
C09BX02 COSYREL B Perindopril arginine - 5mg, Bisoprolol fumarate - 5mg Tablet, film coated, scored 749,864 L.L
C09BX02 COSYREL B Perindopril arginine - 10mg, Bisoprolol fumarate - 5mg Tablet, film coated, scored 749,864 L.L
A07BA51 CARBOSYLANE B Simethicone (blue-red) - 45mg (blue-red), Activated charcoal (blue-red) - 140mg (blue-red) Capsule 585,915 L.L
R06AX CLARINASE B Loratadine - 5mg, Pseudoephedrine sulfate - 120mg Tablet, repetab 446,156 L.L
R06AX CYPRO-BC B Cyproheptadine HCl - 2mg/5ml, Vitamin B3 - 5mg/5ml, Vitamin B6 - 0.60mg/5ml, Vitamin B2 - 0.75mg/5ml, Vitamin B1 - 0.60mg/5ml, Vitamin C - 20mg/5ml Syrup 449,227 L.L
D08AC52 CYTEAL Solution Antiseptique G Chlorhexidine digluconate - 0.5ml/100ml, Hexamidine - 0.1g/100ml, Chlorocresol - 0.3g/100ml Solution 376,772 L.L
D08AC52 CYTEAL Solution Antiseptique G Chlorhexidine digluconate - 0.5ml/100ml, Hexamidine - 0.1g/100ml, Chlorocresol - 0.3g/100ml Solution 641,409 L.L
R02A CHLORASEPTIC TOTAL SORE THROAT + COUGH LOZENGES WILD CHERRY G Benzocaine - 6mg, Dextromethorphan - 5mg, Menthol - 10mg Lozenge 537,537 L.L
A11AA CAL-VIT G Riboflavine - 9mg/100ml, Cyanocobalamine - 570mcg/100ml, Pyridoxine HCl - 35mg/100ml, Thiamine HCl - 190mg/100ml, Inositol - 150mg/100ml, Nicotinamide - 120mg/100ml, Calcium Pantothenate - 27mg/100ml, Sodium hypophosphite - 70mg/100ml Syrup 163,821 L.L
A11AA COMPLEVIT G Ascorbic acid - 1.32g, Riboflavine - 0.018g, Nicotinamide - 0.264g, Cyanocobalamine - 0.9g, Pyridoxine HCl - 0.132g, Thiamine mononitrate - 0.288g, Iron Ammonium Citrate - 3.6g Syrup 218,854 L.L
A11AB CYPRO-VITA B Vitamin C - 20mg, Vitamin B3 - 5mg, Vitamin B12 - 2.5mg, Vitamin B6 - 0.6mg, Vitamin B2 - 0.75mg, Vitamin B1 - 0.6mg, Vitamin D3 - 167IU, Vitamin A - 1670IU, Cyproheptadine HCl - 4mg Tablet, film coated 409,552 L.L
D10AD51 CLINIDERM T G Tretinoin - 0.025%, Clindamycin (phosphate) - 1% Gel 801,186 L.L
C05BA53 CONTRACTUBEX B Allantoin - 1g/100g, Cepae - 10g/100g, Heparin - 5000IU/100g Gel 498,566 L.L
C05BA53 CONTRACTUBEX B Allantoin - 1g/100g, Cepae - 10g/100g, Heparin - 5,000IU/100g Gel 1,183,925 L.L
D10AD51 CLINIDERM T G Tretinoin - 0.05%, Clindamycin (phosphate) - 1% Gel 890,776 L.L
N04BA02 CARLEVO G Levodopa - 250mg, Carbidopa - 25mg Tablet 796,067 L.L
A08AA62 CONTRAVE B Naltrexone Hydrochloride - 8mg, Bupropion Hydrochloride - 90mg Tablet, prolonged release 11,653,550 L.L
N04BA02 CARLEVO G Levodopa - 100mg, Carbidopa - 25mg Tablet 2,431,715 L.L
N04BA03 COMBIPAR G Levodopa - 100mg, Carbidopa - 25mg, Entacapone - 200mg Tablet, film coated 1,249,926 L.L
B05D CAPD/DPCA 17Solution for peritoneal dialysis stay safe G Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.1838g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 15g/l, Fructose , - up to 0.75g/l Injectable solution 629,916 L.L
N04BA03 COMBIPAR G Levodopa - 150mg, Carbidopa - 37.5mg, Entacapone - 200mg Tablet, film coated 1,324,682 L.L
B05D CAPD/DPCA 19Solution for peritoneal dialysis stay safe G Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.1838g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 22.73g/l, Fructose , - up to 1.1g/l Injectable solution 769,337 L.L
N04BA03 COMBIPAR G Levodopa - 50mg, Carbidopa - 12.5mg, Entacapone - 200mg Tablet, film coated 1,103,403 L.L
B05D CAPD/DPCA 2Solution for peritoneal dialysis stay safe G Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.2573g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 15g/l, Glucose monohydrate - 16.5g/l Injectable solution 735,741 L.L
R03AK06 CYVAX G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,710,712 L.L
B05D CAPD/DPCA 3Solution for peritoneal dialysis G Sodium chloride - 5.786g/l, Sodium-(S)-lactate - 3.925g/l, Calcium chloride 2H2O - 0.2573g/l, Magnesium chloride, 6H2O - 0.1017g/l, Anhydrous glucose - 42.50g/l, Glucose monohydrate - 46.75g/l Injectable solution 769,337 L.L
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