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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
A10BB12 DIAMERIL G Glimepiride - 3mg 3mg Tablet 261,089 L.L
C01CA04 DOPAMINE RENAUDIN G Dopamine HCl - 200mg/5ml 4% Injectable concentrated solution 1,107,326 L.L
N05CM18 DEXMEDETOMIDINE EVER PHARMA G Dexmedetomidine HCl - 400mcg/4ml 400mcg/4ml Injectable concentrate for solution 15,543,897 L.L
N03AG01 DEPAKINE B Sodium Valproate - 400mg 400mg Injectable lyophilised powder for solution+diluent 450,187 L.L
M01AE01 DOLORAZ 400 G Ibuprofen - 400mg 400mg Capsule 295,645 L.L
L01FC01 DARZALEX BioTech Daratumumab - 400mg/20ml 400mg/20ml Injectable concentrate for solution L.L
L01FC01 DARZALEX BioTech Daratumumab - 400mg/20ml 400mg/20ml Injectable concentrate for solution 171,503,274 L.L
C03CA01 DIURESAL G Furosemide - 40mg 40mg Tablet, scored 118,258 L.L
N06AB05 DEPROX G Paroxetine (HCl) - 40mg 40mg Tablet 2,909,099 L.L
H02AB04 DEPO MEDROL B Methylprednisolone acetate - 40mg/ml 40mg/ml Injectable suspension 182,763 L.L
A10BB12 DIAMERIL G Glimepiride - 4mg 4mg Tablet 322,522 L.L
N05AX08 DEPIA G Risperidone - 4mg 4mg Tablet, scored 499,142 L.L
H02AB02 DEXAMETHASONE MEDIS G Dexamethasone Phosphate - 4mg/1ml 4mg/1ml Injectable solution 1,154,361 L.L
M05BA08 DROMEZON G Zoledronic acid - 4mg/5ml 4mg/5ml Injectable concentrate for solution 4,577,128 L.L
B05CX01 DEXTROSE 5% INJECTION USP G Glucose - 5% 5% Injectable solution 158,587 L.L
B05CX01 DEXTROSE 5% INJECTION USP G Glucose - 5% 5% Injectable solution 171,228 L.L
B05CX01 DEXTROSE 5% INJECTION, USP G Glucose - 5% 5% Injectable solution 193,062 L.L
B05CX01 DEXTROSE 5% INJECTION, USP G Glucose - 5% 5% Injectable solution 171,228 L.L
B05CX01 DEXTROSE 5% INJECTION, USP G Glucose - 5% 5% Injectable solution 158,587 L.L
D04AX01 DOXIDERM G Doxepin (HCl) - 5% 5% Cream 1,037,958 L.L
A11CC05 D-VITAL G Vitamin D3 - 50,000IU 50,000IU Capsule, hard 712,620 L.L
A11CC05 DIBASE G Vitamin D3 - 50000IU/2.5ml 50,000IU/2.5ml Solution 755,239 L.L
A11CC05 D-ESTER G Vitamin D3 - 50000IU 50000IU Capsule 1,187,701 L.L
N03AG01 DEPAKINE B Sodium Valproate - 500mg 500mg Tablet, enteric coated 479,752 L.L
N03AG01 DEPAKINE CHRONO B Valproic acid - 145mg, Sodium Valproate - 333mg 500mg Tablet, coated, scored, prolonged release 362,837 L.L
V03AC03 DEFIROX G Deferasirox - 500mg 500mg Tablet, dispersible 38,502,953 L.L
V03AC03 DIFIRAX G Deferasirox - 500mg 500mg Tablet, dispersible 38,637,010 L.L
B02BX01 DICYNONE B Etamsylate - 500mg 500mg Capsule 1,311,590 L.L
C05BX01 DOXIUM B Calcium dobesilate - 500mg 500mg Capsule 2,151,492 L.L
C05BX01 DOXIUM B Calcium dobesilate - 500mg 500mg Capsule 1,323,685 L.L
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