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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
B05XA03 SERUFLEX SODIUM CHLORIDE 0.9% INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 156,288 L.L
C09DA03 VALUSTAR PLUS G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 592,635 L.L
C10BA02 INEGY G Simvastatin - 40mg, Ezetimibe - 10mg Tablet 4,484,594 L.L
D11AX01 MINOXIDIL BAILLEUL G Minoxidil - 2% 2% Solution 2,839,539 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) (Vial) - 500mg, Lidocaine (ampoule) - 500mg Injectable powder for solution+diluent 307,740 L.L
J01RA SPIRAGYL FORTE G Metronidazole - 250mg, Spiramycin - 1,500,000IU Tablet, scored 474,824 L.L
L01AX03 TEGOZOL G Temozolomide - 250mg 250mg Capsule 13,397,927 L.L
L04AA27 FINGOLIMOD ZENTIVA G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule, hard 32,406,715 L.L
M01AE03 SOLKET INFLAMMATION AND PAIN G Ketoprofen Lysine salt - 0.16% 0.16% Spray 946,065 L.L
N03AX18 LACOSAMIDE/GENEPHARM G Lacosamide - 100mg 100mg Tablet 4,856,647 L.L
N06AB06 SERTRA TAD G Sertraline HCl - 100mg 100mg Tablet, film coated 1,124,796 L.L
R02A ALFA-AMYLASE BGR CONSEIL G Alpha-Amylase - 200U.CEIP/ml 200U.CEIP/ml Syrup 384,339 L.L
R06AX13 CLARA G Loratadine (micronised) - 10mg 10mg Tablet 131,697 L.L
A11DB TRILAGAVIT G Vitamin B12 - 1mg, Vitamin B6 - 100mg, Vitamin B1 - 200mg Tablet, film coated 399,121 L.L
B05XA03 SERUFLEX SODIUM CHLORIDE 0.9% INJECTION USP G Sodium chloride - 0.9% 0.9% Injectable solution 165,482 L.L
C09DA03 VIOSTAN PLUS 160/12.5 G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 668,082 L.L
D11AX01 ALOPEXY G Minoxidil - 50mg/ml 5% Solution 896,343 L.L
J01DD04 MEGION-A G Ceftriaxone - 0.5g/2ml, Lidocaine (ampoule) - 0.5g/2ml Injectable powder + solvent 355,840 L.L
J01XA01 VANCO MEDIS 500MG G Vancomycin - 500mg 500mg Injectable powder for solution 998,475 L.L
L01AX03 TEMOZOLOMIDE ACCORD G Temozolomide - 250mg 250mg Capsule, hard 13,397,927 L.L
L04AA27 LYXIA G Fingolimod Hydrochloride - 0.5mg 0.5mg Capsule, hard 32,406,715 L.L
N03AX18 TREPADIO G Lacosamide - 100mg 100mg Tablet, film coated 5,202,014 L.L
N06AB06 SOLOTIK G Sertraline HCl - 100mg 100mg Tablet, film coated 616,824 L.L
R02A ANGINOVAG G Lidocaine HCl - 100mg/100ml, Hydrocortisone acetate - 60mg/100ml, Tyrothricin - 400mg/100ml, Dequalinium chloride - 100mg/100ml, ?-Glycerrhetinic acid - 60mg/100ml Spray 651,764 L.L
R06AX13 LORADAD G Loratadine - 10mg 10mg Tablet 131,697 L.L
L01XG01 BORTEZOMIB NEAPOLIS G Bortezomib - 3.5mg 3.5mg Injectable lyophilised powder for solution L.L
A11DB 3V G Vitamin B12 - 1mg/3ml, Vitamin B6 - 100mg/3ml, Vitamin B1 - 100mg/3ml Injectable solution 198,889 L.L
B05XA03 SERUFLEX SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9% 0.9% Injectable solution 176,974 L.L
C07AB07 APO-BISOPROLOL G Bisoprolol fumarate - 5mg 5mg Tablet 923,220 L.L
D11AX01 ALOPEXY G Minoxidil - 5% 5% Solution 896,343 L.L
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