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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
N02BE01 ADOL G Paracetamol - 500mg 500mg Caplet 81,974 L.L
N02BE51 ADOL EXTRA G Paracetamol - 500mg, Caffeine - 65mg Caplet 122,290 L.L
M01AE51 ADVIL COLD & SINUS B Ibuprofen - 200mg, Pseudoephedrine HCl - 30mg Caplet, coated 288,926 L.L
C09DB01 ARBITEN AM 5/160 G Amlodipine - 5mg, Valsartan - 160mg Caplet, film coated 857,372 L.L
C09DB01 ARBITEN AM 10/160 G Amlodipine - 10mg, Valsartan - 160mg Caplet, film coated 857,372 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 5mg 5mg Capsule 794,211 L.L
L04AX04 APO-LENALIDOMIDE G Lenalidomide - 5mg 5mg Capsule 49,795,454 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 10mg 10mg Capsule 1,178,550 L.L
J01CA01 ANTALPEN G Ampicillin (trihydrate) - 250mg 250mg Capsule 218,854 L.L
J01CA01 ANTALPEN G Ampicillin (trihydrate) - 500mg 500mg Capsule 285,407 L.L
L04AX04 APO-LENALIDOMIDE G Lenalidomide - 10mg 10mg Capsule 53,945,075 L.L
J01CA04 AMOXICILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 6,199,145 L.L
J01CA04 AMOXICILLINE ARROW LAB G Amoxicillin (trihydrate) - 500mg 500mg Capsule 564,414 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 500mg 500mg Capsule 254,690 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 500mg 500mg Capsule 7,332,097 L.L
A02BC01 AXIPRON G Omeprazole - 20mg 20mg Capsule 373,358 L.L
J01CA04 AMOXYCILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 4,073,187 L.L
L04AX04 APO-LENALIDOMIDE G Lenalidomide - 15mg 15mg Capsule 56,434,848 L.L
L04AX04 APO-LENALIDOMIDE G Lenalidomide - 25mg 25mg Capsule 58,924,620 L.L
L01XX35 ANAGRELIDE BIOGARAN G Anagrelide - 0.5mg 0.5mg Capsule 15,754,068 L.L
J01FA10 AZOMYCIN G Azithromycin (dihydrate) - 250mg 250mg Capsule 361,494 L.L
J01FA10 AZOMYNE G Azithromycin (dihydrate) - 250mg 250mg Capsule 385,683 L.L
J01FA10 AZOX 250 G Azithromycin (dihydrate) - 250mg 250mg Capsule 346,711 L.L
A11CC05 ALTO D 10.000 G Vitamin D3 - 10,000IU 10,000IU Capsule 895,895 L.L
A11CC05 ALTUM-D3 G Vitamin D3 - 10,000IU 10,000IU Capsule 561,342 L.L
N03AX12 APO-GABAPENTIN G Gabapentin - 300mg 300mg Capsule 2,260,343 L.L
M01AE01 ADVIL LIQUI-GELS B Ibuprofen - 200mg 200mg Capsule 464,970 L.L
M01AE01 ADVIL LIQUI-GELS EXTRA STRENGTH B Ibuprofen - 400mg 400mg Capsule 575,165 L.L
G04CB02 AVODART B Dutasteride - 0.5mg 0.5mg Capsule 2,660,787 L.L
N02AJ13 ALGODOL G Paracetamol - 325mg, Tramadol HCl - 37.5mg Capsule 317,403 L.L
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