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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
N01AB07 SUPRANE (DESFLURANE, USP) B Desflurane - Inhalation 9,371,654 L.L
A03AX13 SIMETHICONE G Dimethicone - 2g/100ml 2g/100ml Emulsion 212,327 L.L
A07BC05 SMECTALIA B Diosmectite - 3g/sachet 3g/sachet Powder for suspension 935,570 L.L
A07BC05 SMECTALIA STRAWBERRY B Diosmectite - 3g/sachet 3g/sachet Powder for suspension 935,570 L.L
J05AG03 STOVIRENZ G Efavirenz - 600mg 600mg Tablet, film coated 6,857,456 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 1000mg 12.5mg/1000mg Tablet, film coated 3,399,653 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 1000mg 12.5mg/1000mg Tablet, film coated 3,399,653 L.L
A10BD20 SYNJARDY B Empagliflozin - 12.5mg, Metformin HCl - 850mg 12.5mg/850mg Tablet, film coated 3,287,711 L.L
A10BD20 SYNJARDY B Empagliflozin - 5mg, Metformin HCl - 1000mg 5mg/1000mg Tablet, film coated 3,399,653 L.L
A10BD20 SYNJARDY B Empagliflozin - 5mg, Metformin HCl - 850mg 5mg/850mg Tablet, film coated 3,287,711 L.L
D10AF02 SPOTEX G Erythromycin - 4% 4% Gel 854,684 L.L
N06AX27 SPRAVATO B Esketamine (HCl) - 28mg 28mg/device Solution 66,978,978 L.L
N06AX27 SPRAVATO B Esketamine (HCl) - 28mg 28mg/device Solution 44,561,381 L.L
N06AX27 SPRAVATO B Esketamine (HCl) - 28mg 28mg/device Solution 25,122,440 L.L
N06AX27 SPRAVATO B Esketamine - 28mg/device 28mg/device Solution 25,122,440 L.L
A02BC05 SOLEZOL G Esomeprazole - 40mg 40mg Injectable powder for solution 301,021 L.L
M04AA03 STABURIC G Febuxostat - 120mg 120mg Tablet, film coated 1,420,889 L.L
M04AA03 STABURIC G Febuxostat - 40mg 40mg Tablet, film coated 1,081,345 L.L
M04AA03 STABURIC G Febuxostat - 80mg 80mg Tablet, film coated 1,355,489 L.L
G04CB01 STERIBO G Finasteride - 1mg 1mg Tablet, film coated 2,636,619 L.L
G04CB01 STERIFINE 5 G Finasteride - 5mg 5mg Tablet, film coated 733,354 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 18,264,981 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule 17,079,643 L.L
L04AA27 SCLEMOD G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule L.L
J02AC01 STABILANOL G Fluconazole - 100mg 100mg Capsule 1,432,331 L.L
J02AC01 STABILANOL G Fluconazole - 150mg 150mg Capsule 264,637 L.L
J02AC01 STABILANOL G Fluconazole - 2mg/ml 2mg/ml Injectable solution 1,291,789 L.L
N06CA02 SERNIL G Flupentixol - 0.5mg, Melitracen - 10mg Tablet 1,003,402 L.L
R03AK07 SYMBICORT B Formoterol fumarate dihydrate - 4.5mcg/Inhalation, Budesonide - 160mcg/Inhalation Inhalation powder 3,378,420 L.L
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