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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
D06BB03 CIVAR G Aciclovir - 5% 5% Cream 507,972 L.L
G03GA01 CHORIOMON BioHuman Human Chorionic Gonadotrophin - 5,000IU 5,000IU Injectable lyophilised powder for solution+diluent 6,306,653 L.L
B03BA01 COBAL G Vitamin B12 - 500mcg 500mcg Tablet, coated 486,471 L.L
B03BA05 COBAL G Mecobalamine - 500mcg/ml 500mcg/ml Injectable solution 1,128,828 L.L
J01FA09 CLAREM 500 G Clarithromycin - 500mg 500mg Tablet, film coated 686,704 L.L
N03AG01 CONVULEX RETARD G Sodium Valproate - 500mg 500mg Tablet, prolonged release 423,310 L.L
J01MA02 CIPROBAY B Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 654,451 L.L
J01MA02 CIPRO G Ciprofloxacin - 500mg 500mg Tablet, film coated 436,749 L.L
J01MA02 CIPROCIN G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film-scored 240,548 L.L
J01MA02 CIPRODAR G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 392,402 L.L
J01MA02 CIPROFAR G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film-scored 241,892 L.L
J01MA02 CIPROLON 500 G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 295,645 L.L
J01MA02 CIPROMAX G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 392,402 L.L
J01MA02 CIPROMID G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film coated 331,929 L.L
J01MA02 CIPROPHARM G Ciprofloxacine (HCl) - 500mg 500mg Tablet, film-scored 354,774 L.L
J01DB05 CEFADRIL G Cefadroxil (monohydrate) - 500mg 500mg Capsule 450,187 L.L
L04AA06 CELLCEPT B Mycophenolate mofetil - 500mg 500mg Tablet 6,083,575 L.L
J01DC02 CEFORA G Cefuroxime (axetil) - 500mg 500mg Tablet 703,918 L.L
J01DC02 CEFUREX G Cefuroxime - 500mg 500mg Tablet 490,503 L.L
J01DC02 CEFUZIME G Cefuroxime (axetil) - 500mg 500mg Tablet, film coated 490,503 L.L
J01DC04 CECLOR MR B Cefaclor (monohydrate) - 500mg 500mg Tablet, film coated, modified release 1,226,096 L.L
J01DC10 CEFPROZ G Cefprozil - 500mg 500mg Tablet, film coated 1,737,588 L.L
A12AA04 CALPEROS G Calcium (carbonate) - 500mg 500mg Tablet 630,262 L.L
G01AF02 CANAGYN G Clotrimazole - 500mg 500mg Tablet 302,365 L.L
L01BC06 CAPECITABINE ACCORD G Capecitabine - 500mg 500mg Tablet, film coated 10,908,012 L.L
L01BC06 CAPECITABINE BIOGARAN G Capecitabine - 500mg 500mg Tablet, coated 12,123,049 L.L
L01BC06 CAPECITABINE GP PHARM G Capecitabine - 500mg 500mg Tablet, film coated 8,869,508 L.L
L01BC06 CAPECITABINE NEAPOLIS G Capecitabine - 500mg 500mg Tablet, film coated 11,222,829 L.L
L01BC06 CAPECITABINE SHILPA G Capecitabine - 500mg 500mg Tablet, film coated 7,396,894 L.L
L01BC06 CAPECITABINE SPC G Capecitabine - 500mg 500mg Tablet, film coated 12,665,771 L.L
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