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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
H04AA01 GLUCAGEN BioTech Glucagon HCl - 1mg 1mg Injectable powder for solution+diluent 1,343,444 L.L
L01BC05 GEMCI-CELL G Gemcitabine (HCl) - 1g/Vial 1g/Vial Injectable concentrate for solution 9,326,123 L.L
L01BC05 GEMCITABIN EBEWE G Gemcitabine (HCl) - 1g/100ml 1g/100ml Injectable concentrated solution 7,512,674 L.L
L01BC05 GEMCITABINE THYMOORGAN G Gemcitabine (HCl) - 1g 1g Injectable powder for solution 5,843,027 L.L
L01BC05 GEMNIL G Gemcitabine (HCl) - 1g 1g Injectable powder for solution 3,369,013 L.L
A04AD GRAVOL B Dimenhydrinate - 15mg/5ml 15mg/5ml Liquid 258,018 L.L
C09CA04 GIZLAN G Irbesartan - 150mg 150mg Tablet, film coated 748,520 L.L
N02BF02 GABRIKA 150 G Pregabalin - 150mg 150mg Capsule 819,104 L.L
H01AC01 GENOTROPIN GOQUICK BioTech Somatropin recombinant - 12mg/ml 12mg/ml Injectable powder for solution+diluent 25,170,264 L.L
G02AX GYNOCIN G Oxytocin - 10IU/ml 10IU/ml Injectable concentrate for solution 626,231 L.L
A10AE04 GLARTUS BioTech Insulin glargine - 100U/ml 100U/ml Injectable solution 1,346,530 L.L
L01EA01 GLIVEC B Imatinib (mesylate) - 100mg 100mg Tablet, film coated 50,531,993 L.L
L01EA01 GLIMATINIB BENTA G Imatinib (mesylate) - 100mg 100mg Tablet, film coated 17,619,185 L.L
L01EA01 GLIMATINIB BENTA G Imatinib (mesylate) - 100mg 100mg Tablet, film coated 43,103,200 L.L
N03AX12 GABATREX G Gabapentin - 100mg 100mg Capsule 292,958 L.L
J01AA02 GRANUDOXY G Doxycycline (monohydrate) - 100mg 100mg Tablet, film-scored 318,491 L.L
J01AA02 GRANUDOXY G Doxycycline (monohydrate) - 100mg 100mg Tablet, film-scored 282,207 L.L
N02BF02 GABRIKA 100 G Pregabalin - 100mg 100mg Capsule 798,626 L.L
A04AD GRAVOL B Dimenhydrinate - 100mg 100mg Suppository 294,302 L.L
N03AA02 GARDENAL B Phenobarbital - 100mg 100mg Tablet 120,946 L.L
L01FA03 GAZYVA BioTech Obinutuzumab - 1000mg/40ml 1000mg/40ml Injectable concentrate for solution L.L
L01FA03 GAZYVA BioTech Obinutuzumab - 1000mg/40ml 1000mg/40ml Injectable concentrate for solution 314,437,416 L.L
A10BA02 GLUCOBAS G Metformin - 1000mg 1000mg Tablet 302,045 L.L
A10BA02 GLUCOPHAGE XR B Metformin HCl - 1000mg 1000mg Tablet, prolonged release 755,039 L.L
L01BC05 GEMCITABINE NEAPOLIS G Gemcitabine (HCl) - 1000mg 1000mg Injectable powder for solution 4,942,653 L.L
J06BA02 GAMUNEX-C BioHuman Human normal immunoglobulin G - 10% 10% Injectable solution 39,990,287 L.L
A10BA02 GLUCOPHAGE B Metformin HCl - 1,000mg 1,000mg Tablet, film coated 624,963 L.L
A10BA02 GLUFORIN XR 1000 G Metformin HCl - 1000mg 1,000mg Tablet, film coated, extended release 579,772 L.L
L01BC05 GEMTABINE 1000 G Gemcitabine HCl - 1,000mg 1,000mg Injectable lyophilised powder for solution 4,882,628 L.L
P03AB02 GAMMA BENZENE HEXACHLORIDE G Lindane - 1% 1% Shampoo 195,817 L.L
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