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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
N06DX01 EBIXA B Memantine - 20mg 20mg Tablet, film coated 4,004,651 L.L
L01XJ01 ERIVEDGE B Vismodegib - 150mg 150mg Capsule 465,368,012 L.L
A10BD21 ENFORZA B Saxagliptin HCl - 5mg, Dapagliflozin - 10mg Tablet, film coated 6,072,824 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution L.L
J05AP55 EPCLUSA B Sofosbuvir - 400mg, Velpatasvir - 100mg Tablet, film coated 991,921,769 L.L
D07AC13 ELOCOM B Mometasone furoate - 1mg/g 0.1% Lotion 282,207 L.L
B01AF02 ELIQUIS B Apixaban - 5mg 5mg Tablet, film coated 4,183,603 L.L
R05CB01 EXOMUC B N-acetylcysteine - 200mg 200mg Granules for solution 529,474 L.L
B01AF02 ELIQUIS B Apixaban - 2.5mg 2.5mg Tablet, film coated 4,183,603 L.L
C03AA03 ESIDREX B Hydrochlorothiazide - 25mg 25mg Tablet 380,115 L.L
A07BA51 EUCARBON B Rhubarbe - 25mg, Sulfur - 50mg, Senna - 105mg, Vegetal charcoal - 180mg Tablet 795,555 L.L
B02AA02 EXACYL B Tranexamic acid - 500mg/5ml 500mg/5ml Injectable solution 748,520 L.L
N03AB02 EPANUTIN B Phenytoin sodium - 100mg 100mg Capsule 739,113 L.L
N03AB02 EPANUTIN B Phenytoin sodium - 100mg 100mg Capsule 739,113 L.L
M09AX10 EVRYSDI B Risdiplam - 0.75mg/ml 0.75mg/ml Powder 865,644,067 L.L
L02BB05 ERLEADA B Apalutamide - 60mg 60mg Tablet, film coated 264,151,186 L.L
D10AD53 EPIDUO B Adapalene - 0.1%, Benzoyl peroxide - 2.5% Gel 2,088,331 L.L
D10AD53 EPIDUO FORTE B Adapalene - 0.3%, Benzoyl peroxide - 2.5% Gel 2,201,214 L.L
J07BC01 ENGERIX-B 20 B Hepatitis B, purified antigen - 20mcg/ml 20mcg/ml Injectable suspension 1,652,926 L.L
D10AF02 ERYFLUID B Erythromycin base - 40mg/ml 4% Lotion 542,912 L.L
J07BC01 ENGERIX-B 10 B Hepatitis B, surface antigen - 10mcg/0.5ml 10mcg/0.5ml Injectable suspension 1,042,822 L.L
D10AF02 ERYFLUID B Erythromycin base - 4% 4% Lotion 542,912 L.L
N01BB54 EMLA B Prilocaine - 25mg/g, Lidocaine - 25mg/g 5% Cream 1,763,121 L.L
B05DA EXTRANEAL (ICODEXTRIN 7.5%) TWIN BAG B Sodium lactate - 4.5g/l, Magnesium Chloride - 0.051g/l, Calcium chloride - 0.257g/l, Sodium chloride - 5.4g/l, Icodextrin - 75.0 g/l Injectable solution 1,998,025 L.L
B05DA EXTRANEAL (ICODEXTRIN 7.5%) SINGLE BAG B Sodium lactate - 4.5g/l, Magnesium Chloride - 0.051g/l, Calcium chloride - 0.257g/l, Sodium chloride - 5.4g/l, Icodextrin - 75.0 g/l Injectable solution 1,998,025 L.L
C09CA09 EDARBI B Azilsartan medoxomil - 40mg 40mg Tablet 1,846,440 L.L
C09CA09 EDARBI B Azilsartan medoxomil - 80mg 80mg Tablet 2,023,827 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution 764,646 L.L
L01AA01 ENDOXAN B Cyclophosphamide (monohydrate) - 500mg 500mg Injectable powder for solution 764,646 L.L
C10AX09 EZETROL B Ezetimibe - 10mg 10mg Tablet 3,680,849 L.L
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