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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
A10BA02 METFORMINE ARROW LAB G Metformin - 1000mg 1000mg Tablet, film coated, scored 237,860 L.L
N06DX01 MEMANTINE ARROW LAB G Memantine HCl - 10mg 10mg Tablet, film coated, scored 1,404,315 L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant 20,324,991 L.L
A02BC05 METAPRO G Esomeprazole - 40mg 40mg Tablet, gastroresistant 639,669 L.L
L04AA06 MYFORTIC B Mycophenolic acid (sodium) - 360mg 360mg Tablet, gastroresistant L.L
H01BA02 MINIRIN MELT B Desmopressin - 120mcg 120mcg Tablet, Oral lyophilisate 4,970,873 L.L
H01BA02 MINIRIN MELT B Desmopressin - 60mcg 60mcg Tablet, Oral lyophilisate 2,484,765 L.L
A03FA03 MOTIDOL ODT G Domperidone - 10mg 10mg Tablet, orodispersible 259,810 L.L
N05CH01 MELATONINE ARROW LP G Melatonin - 2mg 2mg Tablet, prolonged release 1,716,087 L.L
N05AN01 MANICARB SR-400 G Lithium carbonate - 400mg 400mg Tablet, prolonged release 1,431,192 L.L
B03BB01 MED-FOLIC ACID G Folic acid - 5mg 5mg Tablet, scored 355,798 L.L
J01RA MEDSPIRAGYL G Metronidazole - 125mg, Spiramycin - 750,000IU Tablet, scored 474,824 L.L
N02BE51 MAXIFEN G Paracetamol - 325mg, Ibuprofen - 400mg Tablet, scored 225,254 L.L
M03BC51 MUSCEROL 2 G Paracetamol - 450mg, Orphenadrine (citrate) - 35mg Tablet, scored 177,899 L.L
M03BC51 MUSCEROL EXTRA G Caffeine - 15mg, Paracetamol - 450mg, Orphenadrine citrate - 35mg Tablet, scored 267,489 L.L
C01DX12 MOLSIDOMINE BIOGARAN G Molsidomine - 2mg 2mg Tablet, scored 256,674 L.L
C01DX12 MOLSIDOMINE BIOGARAN G Molsidomine - 2mg 2mg Tablet, scored 713,580 L.L
N06AA21 MEFIDIOMIL B Maprotiline - 25mg 25mg Tablet, sugar coated 909,973 L.L
N06AA21 MEFIDIOMIL B Maprotiline - 75mg 75mg Tablet, sugar coated 958,608 L.L
G03AB03 MICROGYNON '30' B Ethinylestradiol - 0.03mg, Levonorgestrel - 0.15mg Tablet, sugar coated 161,261 L.L
N07AA02 MESTINON B Pyridostigmine bromide - 60mg 60mg Tablet, sugar coated 3,090,838 L.L
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