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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
H02AB02 DEXAMED G Dexamethasone - 8mg/2ml 8mg/2ml Injectable solution 3,547,744 L.L
A10BA02 DIANORM XR 500 G Metformin HCl - 500mg 500mg Tablet, film coated, extended release 349,399 L.L
H02AB02 DEXAMED G Dexamethasone - 8mg/2ml 8mg/2ml Injectable solution 486,471 L.L
H02AB02 DEXAMEDIS FORT G Dexamethasone Phosphate - 8mg/2ml 8mg/2ml Injectable solution 43,003 L.L
H02AB02 DEXAMETHASONE SODIUM PHOSPHATE USP - EIPICO G Dexamethasone (sodium phosphate) - 8mg/2ml 8mg/2ml Injectable solution 185,450 L.L
S01CA01 DEXATOBRIN G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 239,204 L.L
H02AB02 DEXASINA G Dexamethasone Phosphate - 8mg/2ml 8mg/2ml Injectable solution 3,471,145 L.L
M02AA15 DICLOGESIC G Diclofenac sodium (diethylamine) - 10mg/g 1% Gel 135,728 L.L
H02AB02 DEXAMETHASON-PANPHARMA G Dexamethasone - 5mg/1ml 5mg/1ml Injectable solution 368,213 L.L
H02AB02 DEXAMETHASONE MEDIS G Dexamethasone Phosphate - 4mg/1ml 4mg/1ml Injectable solution 1,154,361 L.L
A10BB12 DIAMERIL G Glimepiride - 1mg 1mg Tablet 130,545 L.L
M02AA15 DILO G Diclofenac sodium - 2% 2% Gel 267,489 L.L
A10BB12 DIAMERIL G Glimepiride - 2mg 2mg Tablet 199,657 L.L
A03FA03 DOMPERIDONE BIOGARAN G Domperidone - 10mg 10mg Tablet, coated 116,914 L.L
N06DA02 DONECEPT 5 G Donepezil HCl - 5mg 5mg Tablet, film coated 1,970,969 L.L
N06DA02 DONEPEZIL ARROW G Donepezil HCl - 5mg 5mg Tablet, film coated 1,365,344 L.L
S01EC03 DORZOLAMIDE BGR G Dorzolamide HCl - 20mg/ml 20mg/ml Drops solution 517,379 L.L
N06DA02 DONEPEZIL BIOGARAN G Donepezil HCl - 5mg 5mg Tablet, coated 1,325,029 L.L
L01BC06 DIROGIT G Capecitabine - 500mg 500mg Tablet, film coated 11,330,804 L.L
N06DA02 DOPEZIL G Donepezil HCl - 5mg 5mg Tablet, film coated 1,034,759 L.L
A10BB12 DIAMERIL G Glimepiride - 3mg 3mg Tablet 261,089 L.L
S01ED51 DORZOLAMIDE/TIMOLOL BGR G Timolol maleate - 5mg/ml, Dorzolamide HCl - 20mg/ml Drops solution 689,391 L.L
V03AC03 DEFIROX G Deferasirox - 500mg 500mg Tablet, dispersible L.L
S01ED51 DORZOPTIC PLUS G Timolol - 0.5%, Dorzolamide HCl - 2% Drops solution 548,288 L.L
A03FA03 DOMIDONE CHAPHA SUGAR FREE G Domperidone - 5mg/5ml 5mg/5ml Suspension 319,963 L.L
N06DA02 DONECEPT 10 G Donepezil HCl - 10mg 10mg Tablet, film coated 2,292,595 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 189,262 L.L
N06DA02 DONEPEZIL ARROW G Donepezil HCl - 10mg 10mg Tablet, film coated 1,365,344 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 182,720 L.L
N06DA02 DONEPEZIL BIOGARAN G Donepezil HCl - 10mg 10mg Tablet, coated 1,325,029 L.L
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