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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
C09AA05 APO-RAMIPRIL G Ramipril - 2.5mg 2.5mg Capsule 463,626 L.L
C09AA05 ACURIL G Ramipril - 10mg 10mg Tablet 810,337 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 10mg 10mg Capsule 1,178,550 L.L
C07AA05 APO-PROPRANOLOL G Propranolol HCl - 40mg 40mg Tablet, scored 356,118 L.L
C07AA05 APO-PROPRANOLOL G Propranolol HCl - 10mg 10mg Tablet, scored 280,863 L.L
C10AA03 APO-PRAVASTATIN G Pravastatin Sodium - 40mg 40mg Tablet 958,160 L.L
C10AA03 APO-PRAVASTATIN G Pravastatin Sodium - 20mg 20mg Tablet 775,397 L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 3% 3% Injectable solution 2,576,146 L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 1% 1% Injectable solution 1,732,213 L.L
C05BB02 AETHOXYSKLEROL B Polidocanol (Lauromacrogol 400) - 0.5% 0.50% Injectable solution 1,441,943 L.L
N02CX01 APIZINE G Pizotifen - 0.25mg/5ml 0.25mg/5ml Syrup 505,541 L.L
A10BG03 ACTOS B Pioglitazone HCl - 30mg 30mg Tablet 2,484,765 L.L
A10BG03 ACTOS B Pioglitazone HCl - 15mg 15mg Tablet 1,243,054 L.L
R01BA53 AURIMEL B Phenylephrine HCl - 5mg/5ml, Sodium citrate - 325mg/5ml, Carbinoxamine maleate - 2mg/5ml, Dextromethorphan HBr - 5mg/5ml Syrup 319,963 L.L
L01BA04 ALIMTA B Pemetrexed (disodium) - 500mg 500mg Injectable concentrated powder for solution 78,813,513 L.L
L01BA04 ALIMTA B Pemetrexed (disodium) - 100mg 100mg Injectable concentrated powder for solution 16,854,009 L.L
N06AB05 APO-PAROXETINE G Paroxetine (HCl) - 20mg 20mg Tablet 983,693 L.L
N02AJ06 ALGOCOD G Paracetamol - 500mg, Codeine phosphate - 30mg Tablet, effervescent 299,677 L.L
N02BE51 A.B.C.-COLD G Paracetamol - 500mg, Chlorphenamine maleate - 4mg, Phenylephrine HCl - 5mg Tablet, film coated 534,977 L.L
N02BE51 ADOL EXTRA G Paracetamol - 500mg, Caffeine - 65mg Caplet 122,290 L.L
N02BE01 ADOL G Paracetamol - 500mg 500mg Caplet 81,974 L.L
N02BE01 ADOL G Paracetamol - 500mg 500mg Suppository 131,697 L.L
N02BE01 ALGIVIC G Paracetamol - 500mg 500mg Suppository 147,183 L.L
N02BE51 ALGIN ADULTS G Paracetamol - 400mg, Caffeine - 50mg Suppository 195,817 L.L
N02AJ13 ALGODOL G Paracetamol - 325mg, Tramadol HCl - 37.5mg Capsule 317,403 L.L
N02BE01 ADOL G Paracetamol - 250mg/5ml 250mg/5ml Suspension, alcohol free 192,169 L.L
N02BE01 ADOL G Paracetamol - 250mg 250mg Suppository 124,977 L.L
N02BE01 ALGIVIC G Paracetamol - 250mg 250mg Suppository 215,015 L.L
N02BE01 ADOL G Paracetamol - 125mg 125mg Suppository 107,507 L.L
N02BE01 ALGIVIC INFANT G Paracetamol - 125mg 125mg Suppository 199,657 L.L
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