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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
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.2% G Sodium chloride - 0.2g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 194,165 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.2% G Sodium chloride - 0.2g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 220,643 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.3% G Sodium chloride - 0.3g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 188,772 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.3% G Sodium chloride - 0.3g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 204,554 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.3% G Sodium chloride - 0.3g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 220,643 L.L
A10BD15 DIAFLOZIN PLUS G Metformin HCl XR - 1000mg, Dapagliflozin - 5mg Tablet, film coated 1,241,710 L.L
A10BD15 DIVINUSMET XR G Dapagliflozin - 5mg, Metformin HCl XR - 1000mg Tablet, extended release 2,900,012 L.L
A10BD15 DIAFLOZIN PLUS G Metformin HCl XR - 1000mg, Dapagliflozin - 10mg Tablet, film coated 2,483,421 L.L
R05CB10 DILAMUC G Dried Ivy leaf extract - 170mg/100ml, Glycyrrhizic acid (Glycyrrhiza Glabra, Liquorice root) - 164mg/100ml, Thyme - 760mg/100ml Syrup 456,906 L.L
R05D DULSANA WITH CODEINE B Menthol - 0.25mg/5ml, Ammonium chloride - 100mg/5ml, Codeine phosphate - 10mg/5ml, Ephedrine HCl - 4mg/5ml, Carbinoxamine maleate - 2mg/5ml Syrup 273,888 L.L
D07AC01 DIPROSONE B Betamethasone (dipropionate) - 0.5mg/g 0.05% Cream 291,614 L.L
D07AD01 DECLOBAN G Clobetasol (propionate) - 0.05% 0.05% Cream 302,045 L.L
D07AD01 DERMASONE G Clobetasol (propionate) - 0.05% 0.05% Cream 119,026 L.L
D07AD01 DECLOBAN G Clobetasol (propionate) - 0.05% 0.05% Ointment 302,045 L.L
R01AA07 DECOZAL G Xylometazoline HCl - 0.05% 0.05% Metered dose spray 155,886 L.L
R01AA07 DECOZAL G Xylometazoline HCl - 0.05% 0.05% Metered dose spray 108,851 L.L
S01XA18 DRYFREE G Ciclosporin - 0.05% 0.05% Drops 2,257,655 L.L
D07AD01 DERMOVATE B Clobetasol (propionate) - 0.5mg/g 0.05% w/w Cream 290,270 L.L
D07AD01 DERMOVATE B Clobetasol (propionate) - 0.5mg/g 0.05% w/w Ointment 290,270 L.L
R01AA07 DECOZAL G Xylometazoline HCl - 0.1% 0.10% Metered dose spray 147,823 L.L
R01AA07 DECOZAL G Xylometazoline HCl - 0.1% 0.10% Drops 145,135 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.10% Cream 521,411 L.L
D10AD03 DIFADERM G Adapalene - 0.1% 0.10% Gel 414,671 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.10% Gel 503,941 L.L
S01BC03 DICLOFTIL G Diclofenac sodium - 0.1% 0.10% Drops solution 1,038,790 L.L
L02AE04 DECAPEPTYL B Triptorelin - 0.1mg 0.1mg Injectable lyophilised powder for solution+diluent 2,366,507 L.L
D10AD03 DIFADERM G Adapalene - 0.3% 0.30% Gel 952,208 L.L
G04CB02 DUTASTERIDE ARROW LAB G Dutasteride - 0.5mg 0.5mg Capsule 1,166,455 L.L
G04CB02 DUTASTERIDE BIOGARAN G Dutasteride - 0.5mg 0.5mg Capsule, soft 1,112,702 L.L
H02AB02 DECADRON B Dexamethasone - 0.5mg 0.5mg Tablet, scored 393,218 L.L
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