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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
S01CA01 API-TOBRASON G Dexamethasone - 1mg/g, Tobramycin - 3mg/g Ointment 243,235 L.L
S01CA01 API-TOBRASON G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 294,302 L.L
R05DA20 ALGOMIEL COUGH SYRUP G Dextromethorphan HBr - 5mg, Carbinoxamine maleate - 2mg Syrup 639,925 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 174,062 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 174,062 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 170,630 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 182,720 L.L
B05CX01 ALDEX G Dextrose, H2O - 5g/100ml 5g/100ml Injectable solution 205,933 L.L
M01AX21 ART G Diacerein - 50mg 50mg Capsule 1,146,298 L.L
D11AX18 ALMIRAL G Diclofenac sodium - 1% w/w 1% w/w Gel 396,434 L.L
M01AB05 ALMIRAL G Diclofenac sodium - 75mg/3ml 75mg/3ml Injectable solution 415,247 L.L
D07XC04 AZONIT - D G Diflucortolone valerate - 1mg/g, Isoconazole nitrate - 10mg/g Cream 225,766 L.L
C08DB01 APO-DILTIAZ G Diltiazem HCl - 60mg 60mg Tablet 545,600 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
N06DA02 ARICEPT B Donepezil HCl - 10mg 10mg Tablet, film coated 3,776,197 L.L
N06DA02 ALZEPIL G Donepezil HCl - 10mg 10mg Tablet 1,908,256 L.L
N06DA02 ARIPEZIL 10 G Donepezil HCl - 10mg 10mg Tablet, film coated 2,292,595 L.L
N06DA02 ARICEPT B Donepezil HCl - 5mg 5mg Tablet, film coated 3,254,787 L.L
N06DA02 ALZEPIL G Donepezil HCl - 5mg 5mg Tablet 1,406,555 L.L
N06DA02 ARIPEZIL 5 G Donepezil HCl - 5mg 5mg Tablet, film coated 1,970,969 L.L
R03DA11 ANSIMAR G Doxofylline - 20mg/ml 20mg/ml Syrup 550,975 L.L
R03DA11 ANSIMAR G Doxofylline - 400mg 400mg Tablet 544,256 L.L
G04CB02 AVODART B Dutasteride - 0.5mg 0.5mg Capsule 2,660,787 L.L
J05AF10 APO-ENTECAVIR G Entecavir - 0.5mg 0.5mg Tablet 28,943,287 L.L
J05AF10 AVIRAVIR G Entecavir monohydrate - 0.5mg 0.5mg Tablet, film coated 32,224,230 L.L
J05AF10 AVIRAVIR G Entecavir monohydrate - 1mg 1mg Tablet, film coated 32,224,230 L.L
C01CA24 ADRENALINE RENAUDIN G Epinephrine (tartrate) - 1mg/ml 1mg Injectable solution 444,812 L.L
B02BD08 ARYOSEVEN RT BioTech Eptacog alfa - 1mg 1mg Injectable powder for solution+diluent 16,902,713 L.L
B02BD08 ARYOSEVEN RT BioTech Eptacog alfa - 1mg 1mg Injectable powder for solution+diluent L.L
N02CD01 AIMOVIG BioTech Erenumab - 70mg/ml 70mg/ml Injectable solution 35,423,371 L.L
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