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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
A11EA CAL-VIT G Riboflavine - 3mg, Cyanocobalamine - 60mcg, Pyridoxine HCl - 5mg, Thiamine mononitrate - 10mg, Inositol - 3mg, Calcium Pantothenate - 3mg Tablet 4,025,128 L.L
A12AA04 CALTRATE 600 B Calcium (carbonate) - 600mg 600mg Tablet 618,168 L.L
N05AA01 CHLORPROMAZINE G Chlorpromazine HCl - 100mg 100mg Tablet 529,858 L.L
A12AA04 CALPEROS G Calcium (carbonate) - 500mg 500mg Tablet 630,262 L.L
N05AA01 CHLORPROMAZINE G Chlorpromazine HCl - 100mg 100mg Tablet 8,719,720 L.L
A12AA04 CI-CAL B Calcium citrate - 250mg 250mg Tablet 694,767 L.L
N05AA01 CHLORPROMAZINE G Chlorpromazine HCl - 50mg 50mg Tablet 332,761 L.L
A12AX CI-CAL+D B Calcium citrate - 250mg, Vitamin D3 - 125IU Tablet 796,899 L.L
A12AX CI-CAL+D B Calcium citrate - 250mg, Vitamin D3 - 1,000IU Tablet 1,118,077 L.L
C07AB07/C09CA CONCOR T 2.5 B Bisoprolol fumarate - 2.5mg, Telmisartan - 40mg Tablet 1,163,209 L.L
C07AB07/C09CA CONCOR T 2.5 B Bisoprolol fumarate - 2.5mg, Telmisartan - 40mg Tablet 2,209,797 L.L
C07AB07/C09CA CONCOR T 5 B Bisoprolol fumarate - 5mg, Telmisartan - 40mg Tablet 1,457,748 L.L
G01AF02 CANAGYN G Clotrimazole - 100mg 100mg Tablet 229,797 L.L
G01AF02 CANESTEN B Clotrimazole - 0.1g 0.1g Tablet 408,528 L.L
C09DA06 CANDESARTAN / HYDROCHLOROTHIAZIDE BIOGARAN G Candesartan cilexetil - 16mg, Hydrochlorothiazide - 12.5mg Tablet 327,898 L.L
G01AF02 CANAGYN G Clotrimazole - 500mg 500mg Tablet 302,365 L.L
C09DA06 CANDESARTAN / HYDROCHLOROTHIAZIDE BIOGARAN G Candesartan cilexetil - 8mg, Hydrochlorothiazide - 12.5mg Tablet 327,898 L.L
J01DD13 CEFODOX G Cefpodoxime (proxetil) - 100mg 100mg Tablet 434,061 L.L
J01DD13 CEFODOX G Cefpodoxime (proxetil) - 200mg 200mg Tablet 851,996 L.L
A03FA08 CINITREX G Cinitapride - 1mg 1mg Tablet 636,981 L.L
B01AC04 CERUVIN G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 240,548 L.L
B01AC04 CLODOR G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 1,148,025 L.L
B01AC04 CLOPIKEY G Clopidogrel (Bisulfate) - 75mg 75mg Tablet 748,520 L.L
M04AC01 COLCHICINE SEID G Colchicine - 1mg 1mg Tablet 382,995 L.L
C01DX12 CORVASAL 4MG B Molsidomine - 4mg 4mg Tablet 492,742 L.L
J01EE01 CO-TRIMOXAZOLE G Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 7,529,090 L.L
J01EE01 CO-TRIMOXAZOLE G Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 183,019 L.L
C01EX CARDIOVITEX G Coenzyme Q10 - 300mg, Magnesium oxide - 100mg Tablet 2,822,069 L.L
A12AX CALPEROS D3 A SUCER B Vitamin D3 - 400IU, Calcium - 500mg Tablet, chewable 667,890 L.L
A12AX CI-CAL+D B Calcium citrate - 250mg, Vitamin D3 - 800IU Tablet, chewable 804,962 L.L
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