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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
L01XG03 NINLARO B Ixazomib - 4mg 4mg Capsule, hard 388,991,058 L.L
A04AA01 NOZAMET G Ondansetron - 4mg 4mg Film, orodispersible 3,234,181 L.L
N04BC09 NEUPRO B Rotigotine - 4mg/24h 4mg/24h Patch 7,292,823 L.L
C01CA03 NORADRENALINE HIKMA G Noradrenaline bitartrate - 4mg/4ml 4mg/4ml Injectable solution 1,279,338 L.L
A04AA01 NAUSETRON G Ondansetron - 4mg/5ml 4mg/5ml Solution 958,608 L.L
A04AA01 NAUSETRON G Ondansetron - 4mg/5ml 4mg/5ml Solution 802,466 L.L
B02BD02 NOVOEIGHT BioTech Turoctocog Alfa - 500IU 500IU Injectable powder for solution+diluent 29,783,973 L.L
B02BD02 NUWIQ BioTech Coagulation Factor VIII recombinant, human (Simoctogog alfa) - 500IU 500IU Injectable powder for solution+diluent 47,418,699 L.L
M01AE02 NOPAIN DS G Naproxen (sodium) - 500mg 500mg Tablet, film coated 235,172 L.L
N02BE01 NOMAL G Paracetamol - 500mg 500mg Tablet 305,884 L.L
C01DA02 NITROJECT INJECTION G Nitroglycerine - 50mg/10ml 50mg/10ml Injectable solution 7,018,889 L.L
M01AE17 NORMODEX G Dexketoprofen (trometamol) - 50mg/2ml 50mg/2ml Injectable solution 329,241 L.L
C01DA02 NITROGLICERINA BIOINDUSTRIA L.I.M. G Nitroglycerine - 50mg/50ml 50mg/50ml Injectable concentrate for solution 1,057,604 L.L
M03AX01 NEURONOX BioTech Clostridium botulinum type A neurotoxin complex - 50units 50units Injectable lyophilised powder for solution 8,904,323 L.L
M01AE02 NAPROXENE SODIQUE ARROW G Naproxen (sodium) - 550mg 550mg Tablet, film coated, scored 255,330 L.L
R01AD11 NASACORT AQ B Triamcinolone acetonide - 55mcg/dose 55mcg/dose Spray, suspension 1,003,850 L.L
R01AD11 NASACORT AQ B Triamcinolone acetonide - 55mcg/dose 55mcg/dose Spray, suspension 1,003,850 L.L
C07AB12 NEBILET B Nebivolol HCl - 5mg 5mg Tablet, scored 694,767 L.L
C07AB12 NEBIVOLOL BIOGARAN G Nebivolol HCl - 5mg 5mg Tablet, scored 529,474 L.L
C07AB12 NEVILOC G Nebivolol HCl - 5mg 5mg Tablet 476,104 L.L
C07AB12 NIVOL G Nebivolol HCl - 5mg 5mg Tablet 590,011 L.L
C07BB12 NIVOL PLUS G Nebivolol HCl - 5mg, Hydrochlorothiazide - 12.5mg 5mg Tablet 609,209 L.L
C08CA01 NIPIDOL G Amlodipine - 5mg 5mg Tablet 255,330 L.L
C09AA05 NORMOPRIL G Ramipril - 5mg 5mg Tablet 474,376 L.L
B02BD08 NOVOSEVEN RT BioTech Eptacog alfa (activated) recombinant - 5mg 5mg (250KIU) Injectable powder for solution+diluent 275,483,041 L.L
H01AC01 NORDITROPIN NORDIFLEX BioTech Somatropin recombinant - 5mg/1.5ml 5mg/1.5ml Injectable solution 7,582,922 L.L
C01DA02 NITRODERM TTS 5 B Glyceryl trinitrate - 5mg/24h 5mg/24h Patch 683,159 L.L
N07AA01 NEOSTIGMINE RENAUDIN G Neostigmine - 5mg/5ml 5mg/5ml Injectable solution 2,460,576 L.L
C08CA05 NIFE-PAR G Nifedipine - 5mg/ml 5mg/ml Solution 38,120,008 L.L
N03AF01 NEUROTOP RETARD G Carbamazepine - 600mg 600mg Tablet, prolonged release 1,569,608 L.L
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