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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
N02BE51 EXTRA STRENGTH HEADACHE RELIEF G Acetaminophen - 250mg, Acetylsalicylic acid - 250mg, Caffeine - 65mg Tablet 353,431 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
S01LA05 EYLEA BioTech Aflibercept - 40mg/ml 40mg/ml Injectable solution L.L
S01LA05 EYLEA BioTech Aflibercept - 40mg/ml 40mg/ml Injectable solution 65,161,855 L.L
S01LA05 EYLEA BioTech Aflibercept - 8mg/0.07ml 8mg/0.07ml Injectable solution 78,332,387 L.L
C09DB01 EXFORGE B Amlodipine - 10mg, Valsartan - 160mg Tablet, film coated 1,333,092 L.L
C09DB01 EXFORGE B Amlodipine - 5mg, Valsartan - 160mg Tablet, film coated 1,333,092 L.L
J02AX06 ECALTA B Anidulafungin - 100mg 100mg Injectable concentrated powder for solution 16,977,343 L.L
L02BB05 ERLEADA B Apalutamide - 60mg 60mg Tablet, film coated 264,151,186 L.L
L02BB05 ERLEADA B Apalutamide - 60mg 60mg Tablet, film coated 264,151,186 L.L
B01AF02 ELIQUIS B Apixaban - 2.5mg 2.5mg Tablet, film coated 4,183,603 L.L
B01AF02 ELAPIX 2.5 G Apixaban - 2.5mg 2.5mg Tablet, film coated 1,970,969 L.L
B01AF02 ELIQUIS B Apixaban - 5mg 5mg Tablet, film coated 4,183,603 L.L
B01AF02 ELAPIX 5 G Apixaban - 5mg 5mg Tablet, film coated 1,970,969 L.L
C10AA05 EMITOR G Atorvastatin - 20mg 20mg Tablet, film coated 822,432 L.L
C10AA05 EMITOR G Atorvastatin - 40mg 40mg Tablet, film coated 1,060,292 L.L
C09CA09 EDARBI B Azilsartan medoxomil - 40mg 40mg Tablet 1,846,440 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 12.5mg Tablet, film coated 1,846,440 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 25mg Tablet, film coated 1,846,440 L.L
C09CA09 EDARBI B Azilsartan medoxomil - 80mg 80mg Tablet 2,023,827 L.L
J01FA10 ERADECIN G Azithromycin - 250mg 250mg Capsule 354,774 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions Capsule 831,839 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions/5ml Suspension 1,131,515 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions/5ml Suspension 595,322 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 6 Billions/2g 6 billions/2g Powder for suspension 1,493,009 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 6 Billions/2g 6 billions/2g Powder for suspension 1,343,843 L.L
A07EA06 ENTOCORT CIR G Budesonide - 3mg 3mg Capsule, hard, modified release 7,823,588 L.L
A07EA06 ENTOCORT CIR G Budesonide - 3mg 3mg Capsule, hard, modified release 4,771,985 L.L
B05BB02 ELECTROLYE 67 G Calcium gluconate - 0.10g/100ml, Potassium chloride - 0.075g/100ml, Sodium chloride - 0.30g/100ml, Dextrose, H2O - 5.0g/100ml Injectable solution 165,727 L.L
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