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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
M02AA15 LOCAGEL G Diclofenac sodium (diethylamine) - 10mg/g 10mg/g Gel 223,078 L.L
D11AX18 LABDIC RELIEF G Diclofenac sodium - 1%w/w, Methyl salicylate - 8%w/w, Menthol - 2%w/w Gel 263,393 L.L
C01AA05 LANOXIN PG B Digoxin - 0.05mg/ml 0.05mg/ml Elixir 307,740 L.L
C01AA05 LANOXIN B Digoxin - 0.25mg 0.25mg Tablet 215,015 L.L
R05CA12 LIBLAB COUGH SYRUP G Dried Ivy leaf extract - 35mg/5ml 35mg/5ml Syrup 237,860 L.L
R05CA12 LIBLAB COUGH SUPPOSITORIES G Dried Ivy leaf extract - 80mg 80mg Suppository 142,447 L.L
N06AX21 LOXYT 30 G Duloxetine HCl - 30mg 30mg Capsule, delayed release 716,716 L.L
N06AX21 LOXYT 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
B01AB05 LOVENOX BioTech Enoxaparin sodium - 2,000UI (20mg)/0.2ml 2,000UI (20mg)/0.2ml Injectable solution 467,657 L.L
B01AB05 LOVENOX BioTech Enoxaparin sodium - 4,000UI (40mg)/0.4ml 4,000UI (40mg)/0.4ml Injectable solution 886,936 L.L
B01AB05 LOVENOX BioTech Enoxaparin sodium - 6000UI (60mg)/0.6ml 6000UI (60mg)/0.6ml Injectable solution 1,085,825 L.L
B01AB05 LOVENOX BioTech Enoxaparin sodium - 8000UI (80mg)/0.8ml 8000UI (80mg)/0.8ml Injectable solution 1,206,771 L.L
C10AB05 LIPANTHYL B Fenofibrate - 160mg 160mg Tablet, film coated, modified release 1,154,238 L.L
C10AB05 LIPAFIB G Fenofibrate - 160mg 160mg Tablet 627,127 L.L
C10AB05 LIPANTHYL 200 M B Fenofibrate - 200mg 200mg Capsule 1,115,364 L.L
G01AF12 LOMEXIN "T" B Fenticonazole nitrate - 1,000mg 1,000mg Ovule 909,037 L.L
G01AF12 LOMEXIN B Fenticonazole nitrate - 200mg 200mg Ovule 810,359 L.L
D01AC12 LOMEXIN B Fenticonazole nitrate - 2g/100g 2% Cream 758,029 L.L
G01AF12 LOMEXIN B Fenticonazole nitrate - 600mg 600mg Ovule 850,727 L.L
C03CA01 LASIMIDE G Furosemide - 20mg/2ml 20mg/2ml Injectable solution 1,300,328 L.L
C03CA01 LASIX B Furosemide - 40mg 40mg Tablet 120,946 L.L
C03CA01 LASIX B Furosemide - 500mg 500mg Tablet 1,454,038 L.L
C10AB04 LOPID B Gemfibrozil - 600mg 600mg Tablet, film coated 498,566 L.L
C10AB04 LOW-LIP G Gemfibrozil - 600mg 600mg Tablet, film coated 298,333 L.L
A10BB09 LOWZID XR G Gliclazide - 60mg 60mg Tablet, extended release 309,724 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.10% Lipocream 221,734 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.10% Lipocream 221,734 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.10% Lotion 201,576 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.10% Lotion 201,576 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 1mg/g 0.10% Cream 215,015 L.L
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