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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
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 207,894 L.L
N02BE51 DIFEN GESIC G Paracetamol - 400mg, Diclofenac potassium - 50mg Tablet, film coated 330,585 L.L
N06DA02 DOPEZIL G Donepezil HCl - 10mg 10mg Tablet, film coated 1,381,470 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 198,578 L.L
N02BE51 DOLFEIN G Paracetamol - 400mg, Caffeine - 50mg, Codeine phosphate hemihydrate - 20mg Tablet 249,571 L.L
N06DA02 DONEPEZIL/ GENEPHARM G Donepezil - 10mg 10mg Tablet, orodispersible 1,779,247 L.L
A10BB12 DIAMERIL G Glimepiride - 4mg 4mg Tablet 322,522 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.9% G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 226,036 L.L
M03BA53 DISTEM G Paracetamol - 300mg, Methocarbamol - 380mg Tablet 978,317 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 194,211 L.L
N06DA02 DONEPEZIL/ GENEPHARM G Donepezil - 5mg 5mg Tablet, orodispersible 1,634,112 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 180,421 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 186,167 L.L
D04AA32 DERMAMINE ITCH STOPPING G Diphenhydramine HCl - 1%, Zinc acetete - 0.1% Cream 560,382 L.L
A10BD02 DIAMET 500/5 G Metformin HCl XR - 500mg, Glibenclamide - 5mg Tablet, film coated 639,925 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 205,933 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 182,720 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 217,210 L.L
B05BB02 DEXTROSE 5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 240,255 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 193,062 L.L
D04AX01 DOXIDERM G Doxepin (HCl) - 5% 5% Cream 1,037,958 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 180,421 L.L
C01CA04 DOPAMINE FRESENIUS G Dopamine HCl - 200mg/5ml 200mg/5ml Injectable concentrated solution 713,580 L.L
B05BB02 DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 148,566 L.L
C01CA04 DOPAMINE RENAUDIN G Dopamine HCl - 200mg/5ml 4% Injectable concentrated solution 1,107,326 L.L
N05AL07 DISLEP G Levosulpiride - 25mg 25mg Tablet 1,690,682 L.L
C01CA07 DOBUTAMINE PANPHARMA G Dobutamine (HCl) - 250mg/20ml 250mg/20ml Injectable concentrated solution 2,701,123 L.L
L01CD02 DOCETAXEL ACCORD G Docetaxel - 80mg/4ml 80mg/4ml Injectable concentrate for solution 15,099,641 L.L
L01CD02 DOCETAXEL EBEWE G Docetaxel - 80mg/8ml 80mg/8ml Injectable solution 19,518,281 L.L
B05BB02 DEXTROSE 2.5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 2.5g/100ml Injectable solution 176,974 L.L
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