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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
A07AA02 MEDISTAN G Nystatin - 500,000IU/5ml 500,000IU/5ml Suspension 415,951 L.L
P01AB01 METRONIDAZOLE G Metronidazole - 250mg 250mg Tablet 6,540,034 L.L
A07AA02 MEDISTAN G Nystatin - 200.000IU 200.000IU Lozenge 418,511 L.L
P01AB01 METRONIDAZOLE 250 G Metronidazole - 250mg 250mg Tablet 131,825 L.L
D07AC13 METASONE G Mometasone furoate - 0.1% 0.10% Lotion 239,332 L.L
J01CR02 MOXICLAV FORTE G Amoxicillin (trihydrate) - 250mg/5ml, Clavulanic Acid (potassium) - 62.5mg/5ml 312.5mg/5ml Powder for suspension 298,333 L.L
A02BC01 MEDIZOLE GP G Omeprazole - 20mg 20mg Capsule, hard, gastro-resistant 503,941 L.L
J01CR02 MEGAMOX-JPI G Amoxicillin (trihydrate) - 400mg/5ml, Clavulanic Acid (potassium) - 57mg/5ml 457mg/5ml Suspension 435,405 L.L
J01CR02 MOXICLAV BIS G Amoxicillin (trihydrate) - 400mg/5ml, Clavulanic Acid (potassium) - 57mg/5ml 457mg/5ml Powder for suspension 309,084 L.L
R06AA52 MENTEX G Diphenhydramine HCl - 12.5mg/5ml, Dextrometorphan HBr - 15mg/5ml, Pseudoephedrine HCl - 30mg/5ml Syrup 323,866 L.L
D07CA01 MYCICORT G Neomycin sulfate - 5mg/g, Hydrocortisone acetate - 10mg/g Ointment 485,063 L.L
N05CD08 MIDAZOLAM HAMELN G Midazolam (HCl) - 5mg/5ml 5mg/5ml Injectable solution 529,474 L.L
J01CR02 MEGAMOX-JPI ES G Amoxicillin (trihydrate) - 600mg/5ml, Clavulanic Acid (potassium) - 42.9mg/5ml 600mg Powder for suspension 507,972 L.L
N05CD08 MIDAZOLAM NORMON. G Midazolam - 5mg/5ml 5mg/5ml Injectable solution 618,168 L.L
N05CD08 MIDAZOLAM PANPHARMA G Midazolam - 5mg/5ml 5mg/5ml Injectable solution 697,454 L.L
N05CD08 MIDAZOLAM HAMELN G Midazolam (HCl) - 5mg/ml 5mg/ml Injectable solution 561,726 L.L
N05CD08 MIDAZOLAM PANPHARMA G Midazolam - 5mg/ml 5mg/ml Injectable solution 826,463 L.L
J01CR02 MEGAMOX-JPI G Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet 245,923 L.L
L01EB02 MIRATA G Erlotinib (HCl) - 100mg 100mg Tablet, film coated 77,379,009 L.L
N05CH01 MELATONINE ARROW LP G Melatonin - 2mg 2mg Tablet, prolonged release 1,716,087 L.L
J01GB06 MIACIN G Amikacin (sulfate) - 500mg/2ml 500mg/2ml Injectable solution 2,015,764 L.L
N01BB03 MEDICAINE 3% SANS VASOCONSTRICTEUR G Mepivacaine HCl - 3% 3% Injectable solution 954,128 L.L
L01EB02 MIRATA G Erlotinib (HCl) - 150mg 150mg Tablet, film coated 88,599,923 L.L
N01BB53 MEDICAINE 2% WITH ADRENALINE G Mepivacaine HCl - 36mg/1.8ml, Epinephrine (tartrate) - 0.032mg/1.8ml Injectable solution 1,652,926 L.L
J01CR02 MEDIMOX-CV G Amoxicillin - 875mg, Clavulanic Acid - 125mg Tablet 430,030 L.L
J01CR02 MEGAMOX-JPI G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet 456,906 L.L
J07AH MENFIVE G Meningococcal (serogroups A, C, Y, W, X) Polysaccharide conjugate vaccine - Injectable freeze dried powder + diluent 3,527,587 L.L
J01CR02 MOXICLAV G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet 430,030 L.L
J07AH08 MENQUADFI G Meningococcal (serogroups A, C, W and Y) conjugate vaccine - Injectable solution 4,859,334 L.L
M01AC56 MOBITIL G Meloxicam - 15mg, Beta-cyclodextrine - 75mg Tablet, film coated 212,327 L.L
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