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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
N05AX08 RISPERDAL B Risperidone - 1mg/ml 1mg/ml Solution 1,377,439 L.L
A06AX05 RESOLOR B Prucalopride succinate - 1mg 1mg Tablet, film coated 3,273,600 L.L
N01AH06 REMIFENTANIL MEDIS G Remifentanil (HCl) - 1mg 1mg Injectable powder 1,101,951 L.L
A10BX02 REPAGLINIDE ARROW LAB G Repaglinide - 1mg 1mg Tablet 831,839 L.L
L04AA10 RAPAMUNE B Sirolimus - 1mg 1mg Tablet 12,907,489 L.L
L04AA10 RAPAMUNE B Sirolimus - 1mg 1mg Tablet L.L
N04BD02 RASAGILINE BIOGARAN G Rasagiline - 1mg 1mg Tablet 5,214,109 L.L
N04BD02 RAZYLECT 1 G Rasagiline mesylate - 1mg 1mg Tablet 3,532,514 L.L
N05AX08 RISPERDAL B Risperidone - 1mg 1mg Tablet, film coated 323,866 L.L
N05AX08 RISPERDAL B Risperidone - 1mg 1mg Tablet, film coated 323,866 L.L
N05AX08 RESPAL 1 G Risperidone - 1mg 1mg Caplet, film coated 309,084 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 1mg 1mg Tablet, coated, scored 643,701 L.L
N05AX08 RISCHOTIC OD 1 G Risperidone - 1mg 1mg Tablet, orally disintegrating 371,157 L.L
A11GA01 REDOXON EFF.ORANGE B Ascorbic acid (vit C) - 1g 1g Tablet, effervescent 366,869 L.L
J01DD04 ROCEPHIN IV B Ceftriaxone (sodium) - 1g 1g Injectable lyophilised powder for solution+diluent 757,927 L.L
J01DD04 ROCEPHIN IM B Ceftriaxone (sodium) - 1g 1g Injectable lyophilised powder for solution+diluent 731,050 L.L
J01DD04 ROCICARE G Ceftriaxone - 1g 1g Injectable powder for solution 9,382,061 L.L
J01DH02 ROPENEM 1000 BENTA G Meropenem (trihydrate) - 1000mg 1g Injectable powder for solution 995,723 L.L
L04AA44 RINVOQ B Upadacitinib - 15mg 15mg Tablet, prolonged release 45,469,094 L.L
L04AX04 REVLIMID B Lenalidomide - 15mg 15mg Capsule 116,241,703 L.L
B01AF01 RIBAVAN G Rivaroxaban - 15mg 15mg Tablet, film coated 1,343,843 L.L
B01AF01 RIXALTA 15 G Rivaroxaban - 15mg 15mg Tablet, film coated 1,164,664 L.L
C01BC03 RYTMONORM B Propafenone HCl - 150mg 150mg Tablet, film coated 1,119,850 L.L
L03AB07 REBIF BioTech Interferon beta-1a - 44mcg/0.5ml 12MIU Injectable solution 82,479,505 L.L
L03AB07 REBIF BioTech Interferon beta-1a - 44mcg/0.5ml 12MIU Injectable solution L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 91,457,321 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 179,063,666 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 52,597,003 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 179,063,666 L.L
L04AB02 REMSIMA SC BioTech Infliximab - 120mg/ml 120mg/ml Injectable solution 91,457,321 L.L
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