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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
P01AB01 METRIS G Metronidazole - 500mg/100ml 0.50% Injectable solution 142,447 L.L
J01DD04 MEGION-A G Ceftriaxone - 0.5g/2ml, Lidocaine (ampoule) - 0.5g/2ml Injectable powder + solvent 355,840 L.L
N07AA01 METHYL SULFATE DE NEOSTIGMINE RENAUDIN G Neostigmine methyl sulfate - 0.5mg/ml 0.5mg/ml Injectable solution 467,657 L.L
D01AE14 MYCOSTER B Ciclopirox - 1% 1% Cream 325,210 L.L
S01FA06 MYDRIACYL B Tropicamide - 1% 1% Drops solution 430,030 L.L
J01DD04 MESPORIN-1000 IM G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
J01DD04 MESPORIN-1000 IV G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
G03GA02 MENOPUR BioHuman Menotropin - 1,200IU 1,200IU Injectable powder for solution+diluent 27,815,659 L.L
A10BA02 METFORKEY G Metformin HCl - 1.000mg 1.000mg Tablet, extended release 374,932 L.L
J01CR02 MOXICLAV G Amoxicillin - 1g, Clavulanic Acid - 200mg 1.2g Injectable powder for solution 169,324 L.L
B05BC01 MANNITOL 10% USP INJECTION G Mannitol - 10% 10% Injectable solution 430,943 L.L
B05BC01 MANNITOL 10% USP INJECTION G Mannitol - 10% 10% Injectable solution 326,367 L.L
A11CC05 MAXI-D 10.000 G Vitamin D3 - 10,000IU 10,000IU Capsule 895,895 L.L
B01AD11 METALYSE BioTech Tenecteplase - 10,000IU 10,000IU Injectable powder for solution+diluent 77,815,572 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 1000mg 1000mg Tablet, film coated, scored 237,860 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 1000mg 1000mg Tablet, film coated, scored 689,391 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 1000mg 1000mg Tablet, film coated, scored 237,860 L.L
A10AD01 MIXTARD 30 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
A10AD01 MIXTARD 30 BioTech Insulin (human) - 100IU/ml 100IU/ml Injectable suspension 752,552 L.L
H05BA01 MIACALCIC B Calcitonin (salmon synthetic) - 100IU/ml 100IU/ml Injectable solution 1,720,118 L.L
L01EB02 MIRATA G Erlotinib (HCl) - 100mg 100mg Tablet, film coated 77,379,009 L.L
N06BA07 MODAFINIL ARROW G Modafinil - 100mg 100mg Tablet 5,361,932 L.L
L01BC07 MATURUS G Azacitidine - 100mg 100mg Injectable lyophilised powder 9,401,575 L.L
J02AX05 MEGMENTO G Micafungin (sodium) - 100mg 100mg Injectable powder for solution 17,158,569 L.L
J01AA02 MONODOKS G Doxycycline (hyclate) - 100mg 100mg Capsule 248,611 L.L
L01FA01 MABIXEN 100 BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrate for solution 22,183,393 L.L
L01FA01 MABIXEN 100 BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrate for solution 11,091,696 L.L
L01FA01 MABTHERA BioTech Rituximab - 100mg/10ml 100mg/10ml Injectable concentrated solution 35,722,424 L.L
N02AX02 MABRON G Tramadol HCl - 100mg/2ml 100mg/2ml Injectable solution 146,479 L.L
L01FG01 MVASI BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable concentrate for solution 17,173,671 L.L
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