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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
R05CB01 FLUIMUCIL B N-acetylcysteine - 600mg 600mg Tablet, effervescent 567,102 L.L
R03DX10 FASENRA B Benralizumab - 30mg 30mg Injectable solution 214,213,273 L.L
R03BA05 FLIXOTIDE EVOHALER B Fluticasone propionate - 50mcg/actuation 50mcg/actuation Inhalation suspension 671,921 L.L
R03BA05 FLIXOTIDE EVOHALER B Fluticasone propionate - 125mcg/actuation 125mcg/actuation Inhalation suspension 802,274 L.L
R03BA05 FLIXOTIDE EVOHALER B Fluticasone propionate - 250mcg/actutaion 250mcg/actutaion Inhalation suspension 1,484,946 L.L
R03AK07 FORACORT 400 G Formoterol fumarate - 4.5mcg/inhalation, Budesonide - 400mcg/inhalation Metered dose inhaler 3,104,276 L.L
R03AK07 FORACORT 200 G Formoterol fumarate dihydrate - 4.5mcg/inhalation, Budesonide - 200mcg/inhalation Metered dose inhaler 2,159,555 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 500mcg Capsule, inhalation 3,169,668 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 250mcg Capsule, inhalation 2,487,891 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 100mcg Capsule, inhalation 1,777,706 L.L
P01AB01 FLAGYL B Metronidazole - 250mg 250mg Tablet, film coated 176,043 L.L
P01AB01 FLAGYL B Metronidazole - 500mg 500mg Tablet, film coated 310,428 L.L
N06AB08 FAVERIN B Fluvoxamine maleate - 100mg 100mg Tablet, film-scored 1,291,433 L.L
N06AB03 FLUTIN G Fluoxetine (HCl) - 20mg 20mg Capsule 362,837 L.L
N06AB03 FLUOXETINE BIOGARAN G Fluoxetine (HCl) - 20mg 20mg Capsule 239,204 L.L
N05AB02 FLUPHENAZINE HCl G Fluphenazine (HCl) - 5mg 5mg Tablet, scored 624,567 L.L
N03AX22 FYCOMPA B Perampanel - 10mg 10mg Tablet, film coated 12,176,386 L.L
N03AX22 FYCOMPA B Perampanel - 8mg 8mg Tablet, film coated 10,180,812 L.L
N03AX22 FYCOMPA B Perampanel - 6mg 6mg Tablet, film coated 8,751,127 L.L
N03AX22 FYCOMPA B Perampanel - 4mg 4mg Tablet, film coated 8,751,127 L.L
N03AX22 FYCOMPA B Perampanel - 2mg 2mg Tablet, film coated 1,138,235 L.L
N02BE01 FEBRADOL JOINT G Paracetamol - 665mg 665mg Tablet 289,246 L.L
N02BE01 FEBRADOL G Paracetamol - 500mg 500mg Tablet 327,642 L.L
N01AH01 FENTANYL PANPHARMA G Fentanyl - 0.5mg/10ml 0.5mg/10ml Injectable solution 1,243,054 L.L
N01AH01 FENTANYL MEDIS G Fentanyl (citrate) - 0.5mg/10ml 0.5mg/10ml Injectable solution 1,190,644 L.L
N01AH01 FENTANYL HAMELN G Fentanyl (citrate) - 0.5mg/10ml 0.5mg/10ml Injectable solution 1,206,771 L.L
N01AH01 FENTANYL PANPHARMA G Fentanyl - 0.1mg/2ml 0.1mg/2ml Injectable solution 1,101,951 L.L
M05BB03 FOSAVANCE B Alendronic acid (sodium alendronate) - 70mg, Colecalciferol - 5600IU Tablet 1,988,887 L.L
M05BA04 FOSAMAX 70MG ONCE WEEKLY B Alendronate - 70mg 70mg Tablet 1,988,887 L.L
M04AA03 FEBUXOSTAT BIOGARAN G Febuxostat - 80mg 80mg Tablet, film coated 1,402,972 L.L
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