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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
J05AX18 PREVYMIS B Letermovir - 480mg 480mg Tablet, film coated 961,233,292 L.L
J01MA12 PILOQ G Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 980,365 L.L
G03AD01 PURPLE LINE G Levonorgestrel - 1.5mg 1.5mg Tablet, film coated 1,071,570 L.L
D04AB01 PROCOMIL G Lidocaine - 10% 10% Spray 139,760 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine - 40mg, Tribenoside - 400mg Suppository 399,121 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine HCl - 2g/100g, Tribenoside - 5g/100g Cream 405,840 L.L
A06AB58 PICOPREP B Magnesium oxide - 3.5g, Citric acid - 12g, Sodium picosulfate - 10mg Powder 694,767 L.L
M01AG01 PONSTAN FORTE B Mefenamic acid - 500mg 500mg Tablet, film coated 219,046 L.L
M01AG01 PANGESIC FORTE G Mefenamic acid - 500mg 500mg Tablet, film coated 327,898 L.L
L01BB02 PURI-NETHOL B Mercaptopurine - 50mg 50mg Tablet 830,495 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Tablet, controlled release 4,945,340 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Suppository 4,153,817 L.L
A07EC02 PENTASA B Mesalazine - 1g 1g Enema 2,791,161 L.L
A07EC02 PENTASA XTEND B Mesalazine - 2g 2g Granules for suspension 8,550,789 L.L
A07EC02 PENTASA B Mesalazine - 4g 4g Granules, prolonged release 8,513,063 L.L
G03BB01 PROVIRON B Mesterolone - 25mg 25mg Tablet 391,058 L.L
N02BG09 PENTHROX INHALER B Methoxyflurane - Inhalation 21,080,096 L.L
D07AC14 PRENIDERM G Methylprednisolone aceponate - 0.1% 0.10% Cream 312,283 L.L
P01AB01 POLGYL G Metronidazole - 0.5% 0.50% Injectable solution 134,384 L.L
P01AB01 PHOSVIT G Metronidazole benzoate - 125mg/5ml 125mg/5ml Suspension 207,336 L.L
P01AB01 PHOZOLE G Metronidazole benzoate - 125mg/5ml 125mg/5ml Suspension 207,336 L.L
M01AE02 PROXEN 250 B Naproxen - 250mg 250mg Tablet, film coated 542,912 L.L
M01AE02 PROXEN 500 B Naproxen - 500mg 500mg Tablet, film coated 841,245 L.L
G03DC02 PRIMOLUT NOR B Norethisterone acetate - 5mg 5mg Tablet 296,989 L.L
G03FB01 PROGYLUTON B Norgestrel - 0.5mg (tablet 2), Estradiol valerate - 2mg (tablet 1, tablet 2) Tablet 193,513 L.L
G01AA51 POLYGYNAX B Nystatin - 100,000IU, Polymixin B sulfate - 35,000IU, Neomycin sulfate - 35,000IU Capsule, vaginal 407,184 L.L
N05AH03 PRANZA G Olanzapine - 10mg 10mg Tablet, orodispersible 3,553,120 L.L
N05AH03 PREXAL 10 G Olanzapine - 10mg 10mg Caplet, film coated 881,561 L.L
N05AH03 PREXAL 5 G Olanzapine - 5mg 5mg Caplet, film coated 718,956 L.L
N05AH03 PRANZA G Olanzapine - 5mg 5mg Tablet, orodispersible 1,773,872 L.L
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