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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
R02A ALFA-AMYLASE BGR CONSEIL G Alpha-Amylase - 3,000U.CEIP 3,000U.CEIP Tablet, coated 290,270 L.L
C09CA07 ARBIVASTEL G Telmisartan - 80mg 80mg Tablet 667,890 L.L
L02BX03 ABREMIA G Abiraterone acetate - 250mg 250mg Tablet L.L
J01DC02 AXETINE G Cefuroxime sodium - 750mg 750mg Injectable powder for solution 1,193,332 L.L
N02AJ13 ALGODOL G Paracetamol - 325mg, Tramadol HCl - 37.5mg Capsule 317,403 L.L
R02A ALFA-AMYLASE BGR CONSEIL G Alpha-Amylase - 200U.CEIP/ml 200U.CEIP/ml Syrup 384,339 L.L
R02A ANGINOVAG G Lidocaine HCl - 100mg/100ml, Hydrocortisone acetate - 60mg/100ml, Tyrothricin - 400mg/100ml, Dequalinium chloride - 100mg/100ml, ?-Glycerrhetinic acid - 60mg/100ml Spray 651,764 L.L
M01AE02 ANODYNE 500 G Naproxen - 500mg 500mg Suppository 342,680 L.L
C07AA05 APO-PROPRANOLOL G Propranolol HCl - 10mg 10mg Tablet, scored 280,863 L.L
C10AA07 APO-ROSUVASTATIN G Rosuvastatin (calcium) - 40mg 40mg Tablet 670,577 L.L
N06AB10 APO-ESCITALOPRAM G Escitalopram (oxalate) - 10mg 10mg Tablet 565,758 L.L
G04CA01 ALFOCIN G Alfuzosin HCl - 10mg 10mg Tablet, extended release 858,779 L.L
C07AA05 APO-PROPRANOLOL G Propranolol HCl - 40mg 40mg Tablet, scored 356,118 L.L
G04CA01 ALFUZOSINE BIOGARAN LP G Alfuzosin HCl - 10mg 10mg Tablet, coated, prolonged release 1,115,389 L.L
M01AE03 ARDBEG 80MG ADULTS G Ketoprofen Lysine salt - 80mg 80mg Powder for solution 634,294 L.L
R06AX27 AERIALLERG G Desloratadine - 5mg 5mg Tablet, film coated 400,465 L.L
G04CA01 APO-ALFUZOSIN G Alfuzosin HCl - 10mg 10mg Tablet 2,331,567 L.L
R03AC02 ASMALAT G Salbutamol (sulfate) - 2mg/5ml 2mg/5ml Syrup 177,899 L.L
D10BA01 A-CNOTREN G Isotretinoin - 20mg 20mg Capsule, soft gelatin 1,526,524 L.L
J01DC02 AXETINE G Cefuroxime sodium - 1.5g 1.5g Injectable powder for solution 2,273,782 L.L
R03AC02 ASTHALIN G Salbutamol (sulfate) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 325,210 L.L
G04CA02 APO-TAMSULOSIN CR G Tamsulosin HCl - 0.4mg 0.4mg Tablet 607,417 L.L
L04AA13 AROTAN G Leflunomide - 10mg 10mg Tablet, film coated 1,527,949 L.L
B03BB01 ACFOL G Folic acid - 5mg 5mg Tablet 355,798 L.L
L04AA13 AROTAN G Leflunomide - 20mg 20mg Tablet, film coated 2,014,420 L.L
N02BA51 ASPRIVIT G Acetylsalicylic acid - 500mg, Caffeine - 50mg, Vitamin B1 - 2mg Tablet 186,794 L.L
C07AB03 APO-ATENOL G Atenolol - 50mg 50mg Tablet 327,898 L.L
R06AX27 AERIALLERG G Desloratadine - 0.5mg/ml 0.5mg/ml Syrup 200,233 L.L
C07AB03 ATENOLOL BIOGARAN G Atenolol - 50mg 50mg Tablet, scored 295,645 L.L
J01MA14 AVITAR 400 G Moxifloxacin (HCl) - 400mg 400mg Tablet, film coated 913,813 L.L
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