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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
S01FA04 CICLOPLEGICEDOL G Cyclopentolate HCl - 10mg/ml 10mg/ml Drops solution 459,594 L.L
S01GX09 CONJYCLEAR G Olopatadine (HCl) - 0.1% 0.10% Drops solution 510,660 L.L
S02CA05 CETRAXAL PLUS G Ciprofloxacine HCl monohydrate - 3mg/ml, Fluocinolone acetonide - 0.25mg/ml Drops solution 795,555 L.L
S02D CERULYSE B Xylene - 5g/100g 5g/100g Drops solution 339,992 L.L
S01CA01 CO-AVAZIR G Tobramycin - 0.3%, Dexamethasone - 0.1% Drops suspension 193,513 L.L
N02BE01 CHILDREN'S PANADOL 5-12 YEARS B Paracetamol - 240mg/5ml 240mg/5ml Elixir 356,118 L.L
C05BA53 CONTRACTUBEX B Allantoin - 1g/100g, Cepae - 10g/100g, Heparin - 5000IU/100g Gel 498,566 L.L
C05BA53 CONTRACTUBEX B Allantoin - 1g/100g, Cepae - 10g/100g, Heparin - 5,000IU/100g Gel 1,183,925 L.L
D10AD51 CLINIDERM T G Tretinoin - 0.025%, Clindamycin (phosphate) - 1% Gel 801,186 L.L
D10AD51 CLINIDERM T G Tretinoin - 0.05%, Clindamycin (phosphate) - 1% Gel 890,776 L.L
D10AF01 CLINIDERM G Clindamycin (phosphate) - 1% 1% Gel 712,876 L.L
G03DA04 CRINONE B Progesterone - 8% 8% Gel 4,734,357 L.L
D06BX01 CUTIDERMINE G Metronidazole - 1% 1% Gel 593,850 L.L
J01DC04 CECLOR B Cefaclor (monohydrate) - 250mg/5ml 250mg/5ml Granules for suspension 851,100 L.L
J01DC04 CECLOR B Cefaclor (monohydrate) - 125mg/5ml 125mg/5ml Granules for suspension 487,623 L.L
R03BA01 CLENIL 250 MCG SPRAY B Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 1,166,455 L.L
R03BA01 CORTIS G Beclometasone dipropionate - 250mcg/actuation 250mcg/actuation Inhalation solution 674,609 L.L
R03AK06 CYVAX G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,710,712 L.L
R03BA02 CORTAIR G Budesonide - 1mg/2ml 0.5mg/ml Inhalation suspension for nebuliser 1,209,458 L.L
R03AL02 COMBIVENT B Salbutamol (sulfate) - 2.5mg/2.5ml, Ipratropium bromide - 500mcg/2.5ml Inhaltion solution with nebuliser 745,833 L.L
L01CD04 CABAZITAXEL EVER PHARMA G Cabazitaxel - 60mg/6ml 10mg/ml Injectable concentrate for solution L.L
L01FX28 COLUMVI BioTech Glofitamab - 10mg/10ml 10mg/10ml Injectable concentrate for solution 349,443,660 L.L
L01FX28 COLUMVI BioTech Glofitamab - 2.5mg/2.5ml 2.5mg/2.5ml Injectable concentrate for solution 87,389,307 L.L
L01CD04 CABAZITAXEL EVER PHARMA G Cabazitaxel - 60mg/6ml 10mg/ml Injectable concentrate for solution 56,690,955 L.L
J02AX04 CANCIDAS B Caspofungin (acetate) - 70mg 70mg Injectable concentrated powder for solution 31,611,335 L.L
J02AX04 CASPOFUNGINE STRAGEN G Caspofungin (acetate) - 70mg 70mg Injectable concentrated powder for solution 22,928,852 L.L
J02AX04 CANCIDAS B Caspofungin (acetate) - 50mg 50mg Injectable concentrated powder for solution 25,799,521 L.L
J02AX04 CASPOFUNGINE STRAGEN G Caspofungin (acetate) - 50mg 50mg Injectable concentrated powder for solution 18,712,833 L.L
B05XA01 CHLORURE DE POTASSIUM PROAMP G Potassium chloride - 0.0746g/ml 0.0746g/ml Injectable concentrated solution 1,252,461 L.L
L01DB01 CAELYX B Doxorubicin HCl pegylated liposomes - 20mg/10ml 20mg/10ml Injectable concentrated solution L.L
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