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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
C09AA05 ACURIL G Ramipril - 2.5mg 2.5mg Tablet 497,222 L.L
N05AX12 ABIPREX 10 G Aripiprazole - 10mg 10mg Tablet 1,075,074 L.L
N05AX12 ATYPRAL G Aripiprazole - 10mg 10mg Tablet 712,237 L.L
C09AA05 ACURIL G Ramipril - 5mg 5mg Tablet 614,136 L.L
C10AA02 ATERKEY G Lovastatin - 20mg 20mg Tablet 1,053,573 L.L
C10AA03 APO-PRAVASTATIN G Pravastatin Sodium - 40mg 40mg Tablet 958,160 L.L
J05AF10 APO-ENTECAVIR G Entecavir - 0.5mg 0.5mg Tablet 28,943,287 L.L
N05AX12 ABIPREX 15 G Aripiprazole - 15mg 15mg Tablet 1,075,074 L.L
N05AX12 ATYPRAL G Aripiprazole - 15mg 15mg Tablet 712,237 L.L
C10AA03 APO-PRAVASTATIN G Pravastatin Sodium - 20mg 20mg Tablet 775,397 L.L
M05BA07 APO-RISEDRONATE G Risedronate sodium - 150mg 150mg Tablet 1,034,759 L.L
C09AA05 ACURIL G Ramipril - 10mg 10mg Tablet 810,337 L.L
C10AA05 APO-ATORVASTATIN G Atorvastatin (calcium) - 10mg 10mg Tablet 889,624 L.L
R06AA52 AMYDRAMINE G Diphenhydramine HCl - 13.5mg/5ml, Sodium citrate - 57mg/5ml, Ammonium chloride - 131.5mg/5ml, Menthol - 1mg/5ml Syrup, sugar free 133,040 L.L
R06AB54 ALERGICAL EXPECTORANT B Chlorpheniramine maleate - 50mg/100ml, Guaifenesin - 2000mg/100ml, Dihydroxypropyltheophylline - 500mg/100ml, Paracetamol - 2000mg/100ml Syrup 485,127 L.L
R01BA53 AURIMEL B Phenylephrine HCl - 5mg/5ml, Sodium citrate - 325mg/5ml, Carbinoxamine maleate - 2mg/5ml, Dextromethorphan HBr - 5mg/5ml Syrup 319,963 L.L
R02A ALFA-AMYLASE BGR CONSEIL G Alpha-Amylase - 200U.CEIP/ml 200U.CEIP/ml Syrup 384,339 L.L
R03AC02 ASMALAT G Salbutamol (sulfate) - 2mg/5ml 2mg/5ml Syrup 177,899 L.L
R06AX27 AERIALLERG G Desloratadine - 0.5mg/ml 0.5mg/ml Syrup 200,233 L.L
R03DA11 ANSIMAR G Doxofylline - 20mg/ml 20mg/ml Syrup 550,975 L.L
R05CA ASPECTON COUGH SYRUP G Thyme soft extract - 6.69g/100ml Syrup 588,603 L.L
R05CB06 API-MUCOL G Ambroxol HCl - 15mg/5ml 15mg/5ml Syrup 326,554 L.L
N02CX01 APIZINE G Pizotifen - 0.25mg/5ml 0.25mg/5ml Syrup 505,541 L.L
R05DA20 ALGOMIEL COUGH SYRUP G Dextromethorphan HBr - 5mg, Carbinoxamine maleate - 2mg Syrup 639,925 L.L
N02BE01 ADOL G Paracetamol - 250mg/5ml 250mg/5ml Suspension, alcohol free 192,169 L.L
A02AF02 ACTONORM B Aluminium hydroxide - 220mg/5ml, Magnesium hydroxide - 200mg/5ml, Simethicone - 25mg/5ml Suspension 425,998 L.L
P02CA03 ALBENDA G Albendazole - 100mg/5ml 400mg/20ml Suspension 129,009 L.L
R01AD12 AVAMYS B Fluticasone furoate - 27.5mcg/dose 27.5mcg/dose Suspension 722,987 L.L
R01AD12 AVAMYS B Fluticasone furoate - 27.5mcg/dose 27.5mcg/dose Suspension 722,987 L.L
M01AE01 ALGIFAST PEDIATRIC B Ibuprofen Lysine - 20mg/ml 20mg/ml Suspension 393,746 L.L
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