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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
G03DA04 CRINONE B Progesterone - 8% 8% Gel 4,734,357 L.L
J02AC05 CRESEMBA B Isavuconazonium sulfate - 100mg 100mg Capsule, hard 69,290,804 L.L
N02BE01 CHILDREN'S PANADOL 5-12 YEARS B Paracetamol - 240mg/5ml 240mg/5ml Elixir 356,118 L.L
J02AC05 CRESEMBA B Isavuconazonium sulfate - 200mg 200mg Injectable powder for concentrate for solution 38,436,952 L.L
R03AL02 COMBIVENT B Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide - 500mcg/2.5ml Inhaltion solution with nebuliser 745,833 L.L
A02BB01 CYTOTEC B Misoprostol - 200mcg 200mcg Tablet 737,770 L.L
N05AF05 CLOPIXOL DEPOT B Zuclopenthixol decanoate - 200mg/ml 200mg/ml Injectable solution 512,004 L.L
N05AF05 CLOPIXOL ACUPHASE B Zuclopenthixol acetate - 100mg/2ml 100mg/2ml Injectable solution 857,372 L.L
C01DX12 CORVASAL 2MG B Molsidomine - 2mg 2mg Tablet, scored 398,033 L.L
R03BA01 CLENIL 250 MCG SPRAY B Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 873,498 L.L
C01DX12 CORVASAL 2MG B Molsidomine - 2mg 2mg Tablet, scored 1,092,992 L.L
S01AE03 CILOXAN B Ciprofloxacine (HCl) - 3mg/ml 3mg/ml Drops solution 348,055 L.L
C01DX12 CORVASAL 4MG B Molsidomine - 4mg 4mg Tablet 492,742 L.L
C09AA04 COVERSYL ARGININE B Perindopril arginine - 10mg 10mg Tablet, film coated 452,875 L.L
C09AA04 COVERSYL ARGININE B Perindopril arginine - 5mg 5mg Tablet, film coated 452,875 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 27mg 27mg Tablet, extended release 4,393,021 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 36mg 36mg Tablet, extended release 4,393,021 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 54mg 54mg Tablet, extended release 6,049,979 L.L
J05AB06 CYMEVENE B Ganciclovir (sodium) - 500mg 500mg Injectable solution 1,726,838 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 18mg 18mg Tablet, extended release 3,133,841 L.L
A16AB02 CEREZYME B Imiglucerase - 400IU 400IU Injectable lyophilised powder for solution L.L
A07BA51 CARBOSYLANE B Simethicone (blue-red) - 45mg (blue-red), Activated charcoal (blue-red) - 140mg (blue-red) Capsule 585,915 L.L
A07BA51 CARBOSYMAG B Simethicone (green-orange) - 45mg (green-orange), Magnesium oxide (green) - 180mg (green), Activated charcoal (green-orange) - 140mg (green-orange) Capsule 384,339 L.L
G03GB02 CLOMID B Clomifene citrate - 50mg 50mg Tablet 274,144 L.L
C02AC05 CYNT B Moxonidine - 0.2mg 0.2mg Tablet, film coated 937,444 L.L
C02AC05 CYNT B Moxonidine - 0.3mg 0.3mg Tablet, film coated 1,266,372 L.L
A07EA06 CORTIMENT MMX B Budesonide - 9mg 9mg Tablet, prolonged release 8,996,996 L.L
C02AC05 CYNT B Moxonidine - 0.4mg 0.4mg Tablet, film coated 1,266,372 L.L
C02CA04 CARDULAR B Doxazosin (mesylate) - 4mg 4mg Tablet 755,239 L.L
C09BB04 COVERAM B Perindopril arginine - 5mg, Amlodipine - 5mg Tablet 821,088 L.L
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