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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
L01CE02 IRINOGEN G Irinotecan HCl - 100mg 100mg Injectable solution 5,239,642 L.L
J07CA09 INFANRIX HEXA B Diphteria toxoid purified (Prefilled syringe) - ?30IU/0.5ml, Tetanus toxoid purified (prefilled syringe) - ?40IU/0.5ml, Bordetella pertussis antigen (Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg+pertactin 8mcg/0.5ml, Poliomyelitis virus type 1 antigen (prefilled syringe) - 40D.U./0.5ml, Poliomyelitis virus type 2 antigen(prefilled syringe) - 8D.U./0.5ml, Poliomyelitis virus type 3 antigen (prefilled syringe) - 32D.U./0.5ml, HBs Antigen (prefilled syringe) - 10mcg/0.5ml, H. Influenza type b polysaccharide (Vial) - 10mcg/0.5ml Injectable suspension 4,230,416 L.L
J07CA06 INFANRIX IPV + HIB B Poliomyelitis virus type 3 inactivated(Prefilled syringe) - 32D.U., Poliomyelitis virus type 2 inactivated(Prefilled syringe) - 8D.U., Poliomyelitis virus type 1 inactivated(Prefilled syringe) - 40D.U., Bordetella pertussis antigen(Prefilled syringe) - toxoid 25mcg+filamentous haemaglutinin 25mcg+pertactin 8mcg, Tetanus toxoid (Prefilled syringe) - ?40IU, Diphtheria toxoid (Prefilled syringe) - ?30IU, H. Influenza type b polysaccharide(Vial) - 10mcg Injectable dry powder+suspension 3,014,239 L.L
J07BB02 INFLUVAC B Grippal virus surface antigen 3strains - 15mcgx3strains/0.5ml Injectable suspension 573,821 L.L
J07BB01 INFLUVAC TETRA B Influenza virus surface antigens inactivated (haemagglutinin and neuraminidase) - 15mcg/4strains/0.5ml Injectable suspension 970,254 L.L
J06BB04 IMMUNOGLOBULINE HUMAINE DE L'HEPATITE B LFB BioHuman Hepatitis B immunoglobulin (human) - 500UI/5ml 500UI/5ml Injectable solution 26,599,935 L.L
J06BB04 IMMUNOGLOBULINE HUMAINE DE L'HEPATITE B LFB BioHuman Hepatitis B immunoglobulin (human) - 100UI/ml 100UI/ml Injectable solution 6,853,730 L.L
J06BB01 IMMUNORHO BioHuman Human anti-D (rh) immunoglobulin - 300mcg 300mcg Injectable dry powder+diluent 5,794,649 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 1g/20ml 1g/20ml Injectable solution 7,474,948 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 10g/200ml 10g/200ml Injectable solution 55,897,163 L.L
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 2.5g/50ml 5% Injectable solution 14,850,456 L.L
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 5g/100ml 5% Injectable solution 29,700,912 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 5g/100ml 5g/100ml Injectable solution 28,622,366 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 2.5g/50ml 2.5g/50ml Injectable solution 17,011,323 L.L
J02AC02 ITRAZOL G Itraconazole - 100mg 100mg Capsule 559,038 L.L
J02AC02 ITRAZOL G Itraconazole - 100mg 100mg Capsule 149,167 L.L
J01MA12 ILFLOX G Levofloxacin - 500mg 500mg Tablet, film coated 587,259 L.L
J01DH51 IMIPENEME CILASTATINE PANPHARMA G Imipenem (monohydrate) - 500mg, Cilastatin (sodium) - 500mg Injectable powder for solution 9,421,088 L.L
J01DH51 IMIPENEM-CILASTATIN LABATEC G Imipenem (monohydrate) - 500mg, Cilastatin (sodium) - 500mg Injectable powder for solution 8,922,845 L.L
J01DH51 IMILASTIN G Imipenem - 500mg, Cilastatin - 500mg Injectable powder for solution 6,101,612 L.L
J01DH03 INVANZ B Ertapenem - 1g 1g Injectable concentrated powder for solution 3,785,604 L.L
G03AC08 IMPLANON NXT B Etonogestrel - 68mg 68mg Implant 12,299,971 L.L
G01AF05 IFENEC G Econazole nitrate - 150mg 150mg Ovule 546,944 L.L
D10BA01 ISOSUPRA LIDOSE G Isotretinoin - 16mg 16mg Capsule, hard 1,826,282 L.L
D06BA51 IALUGEN PLUS B Silver sulfadiazine - 10mg/g, Sodium hyaluronate - 0.5mg/g Gauze 1,463,444 L.L
D06BA51 IALUGEN PLUS B Silver sulfadiazine - 10mg/g, Sodium hyaluronate - 2mg/g Cream 1,064,323 L.L
D05AA ICHTAMMOL OINTMENT G Tars - 10% 10% Ointment 174,060 L.L
D05AA ICHTAMMOL OINTMENT G Tars - 10% 10% Ointment 90,869 L.L
C10BA02 INEGY G Simvastatin - 40mg, Ezetimibe - 10mg Tablet 4,484,594 L.L
C10BA02 INEGY G Simvastatin - 20mg, Ezetimibe - 10mg Tablet 4,452,598 L.L
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