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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
A02BC05 SOLEZOL G Esomeprazole - 40mg 40mg Injectable powder for solution 301,021 L.L
A11DB MED-PRINCO-B FORT G Vitamin B12 - 200mcg, Vitamin B6 - 200mg, Vitamin B1 - 100mg Tablet, coated 386,515 L.L
B05XA03 ISOTONIC SALINE G Sodium chloride - 0.9% 0.9% Injectable solution 170,630 L.L
C07AB04 ACEBUTOLOL BIOGARAN G Acebutolol HCl - 400mg 400mg Tablet, coated 615,480 L.L
C09DA03 CO-ANGINET G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 544,256 L.L
D11AX01 ALOPEXY G Minoxidil - 20mg/ml 2% Solution 532,162 L.L
G04CB02 DUTASTERIDE ARROW LAB G Dutasteride - 0.5mg 0.5mg Capsule, soft 1,166,455 L.L
J01DD04 LEBACEF G Ceftriaxone (sodium) - 0.5g 0.5g Injectable powder for solution+diluent 511,940 L.L
J01RA MEDSPIRAGYL G Metronidazole - 125mg, Spiramycin - 750,000IU Tablet, scored 474,824 L.L
L01AC01 TEPADINA G Thiotepa - 100mg 100mg Injectable powder for concentrate for solution 98,197,306 L.L
L01EX01 SUNITINIB AQVIDA G Sunitinib maleate - 50mg 50mg Capsule, hard 151,885,541 L.L
M01AE03 ARDBEG 80MG ADULTS G Ketoprofen Lysine salt - 80mg 80mg Powder for solution 634,294 L.L
N02AJ13 MOLCET G Paracetamol - 325mg, Tramadol - 37.5mg Tablet 317,403 L.L
N03AX18 TREPADIO G Lacosamide - 50mg 50mg Tablet, film coated 606,073 L.L
N06AB06 SOLOTIK G Sertraline HCl - 50mg 50mg Tablet, film coated 428,686 L.L
R02A ALFA-AMYLASE BGR CONSEIL G Alpha-Amylase - 3,000U.CEIP 3,000U.CEIP Tablet, coated 290,270 L.L
A11DB NEUROMED G Vitamin B12 - 200mcg, Vitamin B6 - 200mg, Vitamin B1 - 100mg Tablet, coated 257,250 L.L
B05XA03 ISOTONIC SALINE G Sodium chloride - 0.9% 0.9% Injectable solution 166,708 L.L
C07AB04 ACEBUTOLOL BIOGARAN G Acebutolol HCl - 200mg 200mg Tablet, coated 464,970 L.L
C09DA03 CO-TABUVAN G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 544,256 L.L
C10BA02 INEGY G Simvastatin - 20mg, Ezetimibe - 10mg Tablet 4,452,598 L.L
D11AX01 ALOPEXY G Minoxidil - 2% 2% Solution 532,162 L.L
G04CB02 DUTASTERIDE BIOGARAN G Dutasteride - 0.5mg 0.5mg Capsule, soft 1,112,702 L.L
J01DD04 LEBACEF G Ceftriaxone (sodium) - 0.5g 0.5g Injectable powder for solution+diluent 511,940 L.L
J01RA SPIRAGYL G Metronidazole - 125mg, Spiramycin - 750,000IU Tablet, scored 474,824 L.L
M01AE03 SOLKET G Ketoprofen Lysine salt - 80mg 80mg Powder for solution 636,981 L.L
N02AJ13 TRAMADOL/PARACETAMOL ARROW LAB G Tramadol - 37.5mg, Paracetamol - 325mg Tablet, coated 205,608 L.L
N06AB06 PMS-SERTRALINE G Sertraline HCl - 100mg 100mg Capsule 2,015,764 L.L
R06AX13 APOTHECARE LORATADINE G Loratadine - 10mg 10mg Tablet 430,030 L.L
A11DB NEURORUBINE-FORTE G Vitamin B12 - 1mg, Vitamin B6 - 50mg, Vitamin B1 - 200mg Tablet, film coated 262,049 L.L
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