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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
B01AC04 AGGRIX 75 G Clopidogrel besylate - 75mg 75mg Tablet, film coated 1,204,083 L.L
B01AC04 ANTIPLEX G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 1,295,464 L.L
B01AC04 APO-CLOPIDOGREL G Clopidogrel (Bisulfate), - 75mg 75mg Tablet 911,125 L.L
M01AB05 ALMIRAL G Diclofenac sodium - 75mg/3ml 75mg/3ml Injectable solution 415,247 L.L
J07BC02 AVAXIM PEDIATRIQUE (vaccin inactivé de l'hépatite A adsorbé) B Hepatitis A, inactivated, whole virus - 80 antigen units/0.5ml 80 antigen units/0.5ml Injectable suspension 1,531,980 L.L
A07EC02 ASACOL B Mesalazine - 800mg 800mg Tablet 6,833,439 L.L
C09CA03 ANGINET G Valsartan - 80mg 80mg Tablet, film coated 387,027 L.L
C09CA03 ARBITEN 80 G Valsartan - 80mg 80mg Tablet 387,027 L.L
C10AA05 ATORVASTATINE ARROW GENERIQUES G Atorvastatin - 80mg 80mg Tablet, coated 564,414 L.L
C10AA05 ATORVASTATINE ARROW GENERIQUES G Atorvastatin - 80mg 80mg Tablet, coated 564,414 L.L
C09CA07 ARBIVASTEL G Telmisartan - 80mg 80mg Tablet 667,890 L.L
M01AE03 ARDBEG 80MG ADULTS G Ketoprofen Lysine salt - 80mg 80mg Powder for solution 634,294 L.L
M04AA03 ADENURIC B Febuxostat - 80mg 80mg Tablet, film-scored 2,127,111 L.L
A04AD12 APREPITANT BIOGARAN G Aprepitant - 80mg 80mg Capsule 2,164,930 L.L
L04AC07 ACTEMRA BioTech Tocilizumab - 80mg/4ml 80mg/4ml Injectable concentrated solution 11,127,864 L.L
B01AC06 A.S HEART G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 148,463 L.L
B01AC06 ASPI-COR G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 690,735 L.L
B01AC06 ASPICOT G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 353,239 L.L
B01AC06 ASPROTHIN G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 148,463 L.L
C09CA06 ATACAND B Candesartan cilexetil - 8mg 8mg Tablet 526,786 L.L
C09CA06 ANDESART 8 G Candesartan cilexetil - 8mg 8mg Tablet 498,566 L.L
C09CA06 ARKANDA 8 G Candesartan cilexetil - 8mg 8mg Tablet 639,925 L.L
A04AA01 APO-ONDANSETRON G Ondansetron - 8mg 8mg Tablet 1,491,665 L.L
L01ED04 ALUNBRIG B Brigatinib - 90mg 90mg Tablet, film coated 374,059,747 L.L
M01AH05 ARCOXIA B Etoricoxib - 90mg 90mg Tablet, film coated 2,119,240 L.L
M01AH05 ARTRIX 90 G Etoricoxib - 90mg 90mg Tablet, film coated 1,228,656 L.L
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