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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
B03BA01 COBAL G Vitamin B12 - 500mcg 500mcg Tablet, coated 486,471 L.L
C07AB07 CARDIOSAFE 5 G Bisoprolol fumarate - 5mg 5mg Tablet, coated 330,585 L.L
A11JC CYSTINE B6 BAILLEUL B Pyridoxine HCl - 50mg, L-Cystine - 500mg Tablet, coated 862,747 L.L
C07AB07 CARDIOSAFE 10 G Bisoprolol fumarate - 10mg 10mg Tablet, coated 610,104 L.L
L01BC06 CAPECITABINE BIOGARAN G Capecitabine - 500mg 500mg Tablet, coated 12,123,049 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 30mg 30mg Tablet, coated 8,768,039 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 90mg 90mg Tablet, coated, scored 22,062,995 L.L
H05BX01 CINACALCET ARROW BioTech Cinacalcet - 60mg 60mg Tablet, coated, scored 16,494,074 L.L
A11GB CAL-C-VITA EFFERVESCENT B Vitamin B6 - 15mg, Vitamin D - 300IU, Calcium carbonate - 625mg, Ascorbic acid - 1000mg Tablet, effervescent 494,534 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 27mg 27mg Tablet, extended release 4,393,021 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 36mg 36mg Tablet, extended release 4,393,021 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 54mg 54mg Tablet, extended release 6,049,979 L.L
N06BA04 CONCERTA B Methylphenidate HCl - 18mg 18mg Tablet, extended release 3,133,841 L.L
J01FA09 CLAREM 500 G Clarithromycin - 500mg 500mg Tablet, film coated 686,704 L.L
C02AC05 CYNT B Moxonidine - 0.2mg 0.2mg Tablet, film coated 937,444 L.L
C02AC05 CYNT B Moxonidine - 0.3mg 0.3mg Tablet, film coated 1,266,372 L.L
C02AC05 CYNT B Moxonidine - 0.4mg 0.4mg Tablet, film coated 1,266,372 L.L
J05AR01 CONDINE G Lamivudine - 150mg, Zidovudine - 300mg Tablet, film coated 5,818,474 L.L
L01EA01 CEMIVIL G Imatinib - 100mg 100mg Tablet, film coated 12,763,090 L.L
A06AX05 CONSTIPRIDE G Prucalopride succinate - 2mg 2mg Tablet, film coated 2,956,454 L.L
A06AX05 CONSTIPRIDE G Prucalopride succinate - 1mg 1mg Tablet, film coated 2,015,764 L.L
P01BA02 CORVAQUINE G Hydroxychloroquine sulfate - 200mg 200mg Tablet, film coated 1,087,873 L.L
L02BB03 CASODEX B Bicalutamide - 50mg 50mg Tablet, film coated 3,777,541 L.L
L02BB03 CASODEX B Bicalutamide - 150mg 150mg Tablet, film coated 10,863,782 L.L
J01CR02 CURAM G Amoxicillin (trihydrate) - 500mg, Clavulanic Acid (potassium) - 125mg 625mg Tablet, film coated 402,189 L.L
G04BE08 CIALIS B Tadalafil - 20mg 20mg Tablet, film coated 3,101,588 L.L
J01CR02 CURAM G Amoxicillin (trihydrate) - 875mg, Clavulanic Acid (potassium) - 125mg 1g Tablet, film coated 541,236 L.L
J01MA02 CIPROBAY B Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 654,451 L.L
R06AE07 CETALLERG G Cetirizine (dihydrochloride) - 10mg 10mg Tablet, film coated 180,075 L.L
J01MA02 CIPRO G Ciprofloxacin - 500mg 500mg Tablet, film coated 436,749 L.L
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