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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
B01AF02 AVIXAN G Apixaban - 5mg 5mg Tablet, film coated 2,777,275 L.L
C10AA05 ASCOVA G Atorvastatin (calcium) - 20mg 20mg Tablet 1,356,641 L.L
J01FA10 APO-AZITHROMYCIN Z G Azithromycin - 250mg 250mg Tablet 481,096 L.L
A02BC01 ARAPRIDE G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 427,342 L.L
C10AA05 ATOR MEDIS G Atorvastatin - 20mg 20mg Tablet, film coated 591,291 L.L
J01FA10 AZICIN 250 BENTA G Azithromycin - 250mg 250mg Tablet, film coated 423,630 L.L
L01EA02 APO-DASATINIB G Dasatinib - 70mg 70mg Tablet 71,323,688 L.L
A02BC01 AXIPRON G Omeprazole - 20mg 20mg Capsule 373,358 L.L
C10AA05 ATORLIP 20 G Atorvastatin (calcium) - 20mg 20mg Tablet, film coated 1,279,850 L.L
J01CR02 AMOCLAN G Amoxicillin (trihydrate) - 125mg/5ml, Clavulanic Acid (potassium) - 31.25mg/5ml 156mg/5ml Powder for suspension 159,917 L.L
J01FA10 AZIFAST 250 G Azithromycin - 250mg 250mg Tablet, film coated 423,630 L.L
B01AF02 APIXEL G Apixaban - 2.5mg 2.5mg Tablet, film coated 1,750,579 L.L
C10AA05 ATORVA TAD G Atorvastatin - 20mg 20mg Tablet, film coated 1,087,169 L.L
J01FA10 AZOMYCIN G Azithromycin (dihydrate) - 250mg 250mg Capsule 361,494 L.L
B01AF02 APO-APIXABAN G Apixaban - 2.5mg 2.5mg Tablet 3,084,119 L.L
C10AA05 ATORVAKEY-20 G Atorvastatin (calcium) - 20mg 20mg Tablet 362,837 L.L
G04BD08 ASOLFENA G Solifenacin succinate - 10mg 10mg Tablet, film coated 971,598 L.L
J01CR02 AMOCLAN FORTE G Amoxicillin (trihydrate) - 250mg/5ml, Clavulanic Acid (potassium) - 62.5mg/5ml 312mg/5ml Powder for suspension 288,926 L.L
J01FA10 AZOMYNE G Azithromycin (dihydrate) - 250mg 250mg Capsule 385,683 L.L
B01AF02 AVIXAN G Apixaban - 2.5mg 2.5mg Tablet, film coated 2,777,275 L.L
C10AA05 ATORVASTATIN PHARMADEX G Atorvastatin - 20mg 20mg Tablet 769,190 L.L
J01FA10 AZOX 250 G Azithromycin (dihydrate) - 250mg 250mg Capsule 346,711 L.L
C03BA11 ADEX G Indapamide - 1.5mg 1.5mg Tablet, prolonged release 296,989 L.L
C10AA05 ATORVASTATINE ARROW GENERIQUES G Atorvastatin - 20mg 20mg Tablet, coated 567,102 L.L
J01CR02 AMOCLAN BID G Amoxicillin (trihydrate) - 200mg/5ml, Clavulanic Acid (potassium) - 28.5mg/5ml 228.5mg/5ml Powder for suspension 345,368 L.L
J01FA10 AZOX 250 G Azithromycin (dihydrate) - 250mg 250mg Tablet, film coated 354,774 L.L
L01EA02 APO-DASATINIB G Dasatinib - 50mg 50mg Tablet 71,323,688 L.L
N05BA08 ANXYL G Bromazepam - 3mg 3mg Tablet, scored 167,660 L.L
C10AA05 ATORVASTATINE ARROW GENERIQUES G Atorvastatin - 20mg 20mg Tablet, coated 567,102 L.L
J01CR02 AMOCLAN BID G Amoxicillin (trihydrate) - 400mg/5ml, Clavulanic Acid (potassium) - 57.1mg/5ml 457mg/5ml Powder for suspension 278,175 L.L
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