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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
M05BB03 ACIDE ALENDRONIQUE/ VITAMINE D3 BGR G Alendronic acid - 70mg, Colecalciferol - 5600UI Tablet 815,712 L.L
V01AA ACARIZAX 12 SQ-HDM ORAL LYOPHILISATE B Allergen extracts - 12 SQ-HDM Tablet, lyophilised 9,366,451 L.L
A02AF02 ACTONORM B Aluminium hydroxide - 220mg/5ml, Magnesium hydroxide - 200mg/5ml, Simethicone - 25mg/5ml Suspension 425,998 L.L
C09BB04 ANCAVAZ G Amlodipine - 5mg, Perindopril - 5mg Tablet, film coated 491,846 L.L
C09BB04 ANCAVAZ G Amlodipine - 5mg, Perindopril - 10mg Tablet, film coated 669,234 L.L
J01CR02 AMOXICLAV-ORBUCELL G Amoxicillin - 1g, Clavulanic Acid (potassium) - 0.2g Injectable powder for solution 7,433,691 L.L
C02LA51 ADELPHAN ESIDREX B Reserpine - 0.1mg, Hydrochlorothiazide - 10mg, Dihydralazine - 10mg Tablet 371,157 L.L
R05X ACTISOUFRE B Sulfure de Sodium - 13mg, Saccharomyces Cerevisiae - 500mg Solution 740,457 L.L
J01CR02 AMOKLAVIN BID 400/57MG FORTE G Amoxicillin (trihydrate) - 400mg/5ml, Clavulanic Acid (potassium) - 57mg/5ml Powder for suspension 278,175 L.L
R06AA52 AMYDRAMINE G Diphenhydramine HCl - 13.5mg/5ml, Sodium citrate - 57mg/5ml, Ammonium chloride - 131.5mg/5ml, Menthol - 1mg/5ml Syrup, sugar free 133,040 L.L
J01CR02 AMOKLAVIN ES G Amoxicillin (trihydrate) - 600mg/5ml, Clavulanic Acid (potassium) - 42.9mg/5ml Powder for suspension 507,972 L.L
R06AB54 ALERGICAL EXPECTORANT B Chlorpheniramine maleate - 50mg/100ml, Guaifenesin - 2000mg/100ml, Dihydroxypropyltheophylline - 500mg/100ml, Paracetamol - 2000mg/100ml Syrup 485,127 L.L
V07AB01 ARWAN WFI G Water for injection - Water for injection, irrigation 399,915 L.L
J01CR02 AYECLAV-T G Amoxicillin - 875mg, Clavulanic Acid - 125mg Tablet 338,648 L.L
D07XC04 AZONIT - D G Diflucortolone valerate - 1mg/g, Isoconazole nitrate - 10mg/g Cream 225,766 L.L
N01BB58 ARTINIBSA 4% WITH EPINEPHRINE 1/100000 B Articaine HCl - 4%, Epinephrine - 1/100.000 Injectable solution 1,968,729 L.L
N01BB58 ARTICAINE MEDIS ADRENALINE G Articaine HCl - 40mg/ml, Adrenaline - 0.07mg/ml Injectable solution 1,881,380 L.L
C05A ANTROLIN B Nifedipine - 0.3%, Lidocaine - 1.5% Cream 1,333,092 L.L
N02AJ06 ALGOCOD G Paracetamol - 500mg, Codeine phosphate - 30mg Tablet, effervescent 299,677 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
N02AJ08 ASTEFOR G Ibuprofen - 400mg, Codeine phosphate hemihydrate - 30mg Tablet, film coated 935,314 L.L
N02AJ13 ALGODOL G Paracetamol - 325mg, Tramadol HCl - 37.5mg Capsule 317,403 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
J07BX05 ABRYSVO B RSV subgroup A stabilized perfusion F antigen 60mcg - 60mcg, RSV subgroup B stabilized perfusion F antigen 60mcg - 60mcg, Glycoprotein F stabilized in the perfusion conformation - Injectable powder + solvent 22,650,721 L.L
N02BA51 ASPIRINE C EFFERVESCENT B Acetylsalicylic acid - 400mg, Vitamin C - 240mg Tablet, effervescent 162,605 L.L
N02BA51 ASPRIVIT G Acetylsalicylic acid - 500mg, Caffeine - 50mg, Vitamin B1 - 2mg Tablet 186,794 L.L
M01AE51 ADVIL COLD & SINUS B Ibuprofen - 200mg, Pseudoephedrine HCl - 30mg Caplet, coated 288,926 L.L
C09DA03 ARBITEN PLUS G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet 544,256 L.L
C09DA03 ARBITEN PLUS G Valsartan - 160mg, Hydrochlorothiazide - 25mg Tablet 579,196 L.L
L04AA32 APRIVA STARTER PACK G Apremilast - 10mg, Apremilast - 20mg, Apremilast - 30mg Tablet, film coated 22,154,866 L.L
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