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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
N05BA12 PAZOLAM G Alprazolam - 0.5mg 0.5mg Tablet 563,070 L.L
A11CC05 PEDIAVIT D G Vitamin D3 - 400IU 400IU Liquid 550,975 L.L
V03AB35 PLIBADEX G Sugammadex - 500mg/5ml 500mg/5ml Injectable solution 98,646,620 L.L
M01AB55 PANCLO B12 G Diclofenac sodium - 75mg, Betamethasone disodium phosphate - 2mg, Hydroxocobalamin sulphate - 10mg Injectable solution 1,158,392 L.L
G04BX14 PRIXETIN 30 G Dapoxetine (hydrochloride) - 30mg 30mg Tablet, film coated 2,105,353 L.L
L01EF01 PALBRANCE 75 G Palbociclib - 75mg 75mg Capsule 168,011,222 L.L
A11CC05 PEDIAVIT D 800 G Vitamin D3 - 800IU 800IU Liquid 580,540 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 2,822,386 L.L
L01EF01 PAPILLIO G Palbociclib - 75mg 75mg Capsule, hard 147,883,080 L.L
M01AC01 PIROXICAM G Piroxicam - 10mg 10mg Capsule 353,239 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 663,077 L.L
G04BX14 PRIXETIN 60 G Dapoxetine (hydrochloride) - 60mg Tablet, film coated 1,479,123 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 10g/100ml 10g/100ml Injectable solution 3,023,493 L.L
L01EF01 PALBOMED G Palbociclib - 100mg 100mg Capsule 23,911,751 L.L
A02BC05 PRIMAZOL 40 G Esomeprazole (magnesium dihydrate) - 40mg 40mg Capsule, gastro-resistant 639,925 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 15g/100ml 15g/100ml Injectable solution 5,688,441 L.L
L01EF01 PALBRANCE 100 G Palbociclib - 100mg 100mg Capsule 168,011,222 L.L
A02BC05 PROTREX G Esomeprazole - 40mg 40mg Capsule 646,324 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 11.2g/100ml 11.2g/100ml Injectable solution 789,487 L.L
C07AA05 PROBETOL G Propranolol HCl - 10mg 10mg Tablet 126,705 L.L
C10AA08 PIVAL G Pitavastatin - 2mg 2mg Tablet 802,466 L.L
J01MA12 PILOQ G Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 980,365 L.L
L01EF01 PAPILLIO G Palbociclib - 100mg 100mg Capsule, hard 147,883,080 L.L
N01BB54 PRILA G Prilocaine - 2.5% w/w, Lidocaine - 2.5% w/w Cream 1,057,604 L.L
A02BC05 PUMPINOX G Esomeprazole - 40mg 40mg Tablet, enteric coated 649,076 L.L
N01BB54 PRILA G Prilocaine - 2.5% w/w, Lidocaine - 2.5% w/w Cream 1,163,768 L.L
C10AA08 PIVAL G Pitavastatin - 4mg 4mg Tablet 1,265,772 L.L
P02CB01 PIPERAZINE CITRATE G Piperazine citrate - 750mg/5ml 750mg/5ml Elixir 113,907 L.L
C07AA05 PROBETOL G Propranolol HCl - 40mg 40mg Tablet 159,981 L.L
G04CA01 PROSTETROL G Alfuzosin HCl - 10mg 10mg Tablet, modified release 360,150 L.L
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