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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
C05AE03 DILTIGEL G Diltiazem HCl - 2% 2% Gel 632,950 L.L
D10AD03 DIFADERM G Adapalene - 0.1% 0.10% Gel 414,671 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.10% Gel 503,941 L.L
D10AD03 DIFADERM G Adapalene - 0.3% 0.30% Gel 952,208 L.L
D10AF51 DUAC ONCE DAILY B Clindamycin (phosphate) - 1%, Benzoyl peroxide - 5% Gel 1,658,302 L.L
M02AA15 DICLOGESIC G Diclofenac sodium (diethylamine) - 10mg/g 1% Gel 135,728 L.L
M02AA15 DILO G Diclofenac sodium - 2% 2% Gel 267,489 L.L
D05AX52 DAIVOBET B Calcipotriol - 50mcg/g, Betamethasone - 0.5mg/g Gel 2,100,426 L.L
G03DA04 DARSTIN G Progesterone - 10mg/g 10mg/g Gel 380,307 L.L
H02AB02 DECADRON B Dexamethasone - 0.5mg/5ml 0.5mg/5ml Elixir 449,227 L.L
H02AB02 DEXAMETHASONE G Dexamethasone - 0.5mg/5ml 0.5mg/5ml Elixir 119,026 L.L
S01CA01 DEXATOBRIN G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 239,204 L.L
A11CC06 DEDROGYL G Calcifediol - 15mg/100ml 15mg/100ml Drops solution 827,807 L.L
S01BA01 DEXAFREE G Dexamethasone Phosphate - 1mg/ml 1mg/ml Drops solution 563,070 L.L
S01BA01 DEXAFREE G Dexamethasone Phosphate - 1mg/ml 1mg/ml Drops solution 563,070 L.L
S01BC03 DICLOFTIL G Diclofenac sodium - 0.1% 0.10% Drops solution 1,038,790 L.L
S01EC03 DORZOLAMIDE BGR G Dorzolamide HCl - 20mg/ml 20mg/ml Drops solution 517,379 L.L
S01ED51 DORZOLAMIDE/TIMOLOL BGR G Timolol maleate - 5mg/ml, Dorzolamide HCl - 20mg/ml Drops solution 689,391 L.L
S01ED51 DORZOPTIC PLUS G Timolol - 0.5%, Dorzolamide HCl - 2% Drops solution 548,288 L.L
S01ED51 DUOTRAV B Timolol (maleate) - 5mg, Travoprost - 40mcg Drops solution 1,933,789 L.L
R01AA07 DECOZAL G Xylometazoline HCl - 0.1% 0.10% Drops 145,135 L.L
S01XA18 DRYFREE G Ciclosporin - 0.05% 0.05% Drops 2,257,655 L.L
D07AC01 DIPROSONE B Betamethasone (dipropionate) - 0.5mg/g 0.05% Cream 291,614 L.L
D07AD01 DERMOVATE B Clobetasol (propionate) - 0.5mg/g 0.05% w/w Cream 290,270 L.L
D07AD01 DECLOBAN G Clobetasol (propionate) - 0.05% 0.05% Cream 302,045 L.L
D07AD01 DERMASONE G Clobetasol (propionate) - 0.05% 0.05% Cream 119,026 L.L
D07XA01 DAKTACORT B Hydrocortisone - 10mg/g, Miconazole nitrate - 20mg/g Cream 208,296 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.10% Cream 521,411 L.L
D01AC02 DAKTARIN B Miconazole nitrate - 20mg/g 20mg/g Cream 231,141 L.L
D01AC14 DERMOFIX B Sertaconazole nitrate - 20mg/g 2% Cream 382,995 L.L
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