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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
G03DC02 PRIMOLUT NOR B Norethisterone acetate - 5mg 5mg Tablet 296,989 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 5mg 5mg Tablet, film coated 1,890,786 L.L
N05AX12 PIRIFY G Aripiprazole - 5mg 5mg Tablet 614,328 L.L
R06AD02 PROMETHAZINE HYDROCHLORIDE G Promethazine HCl - 5mg/5ml 5mg/5ml Syrup 204,776 L.L
B01AB05 PARINOX 60 BioTech Enoxaparin sodium - 6000IU (60mg)/0.6ml 6000IU (60mg)/0.6ml Injectable solution 438,989 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 24,121,923 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 24,121,923 L.L
M01AE01 PROFINAL G Ibuprofen - 600mg 600mg Tablet 302,365 L.L
G04BX14 PRILIGY B Dapoxetine (hydrochloride) - 60mg 60mg Tablet, film coated 1,957,979 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 60mg 60mg Capsule, delayed release 976,973 L.L
N06BA09 PMS-ATOMOXETINE G Atomoxetine (HCl) - 60mg 60mg Capsule 5,228,891 L.L
M05BX04 PROLIA BioTech Denosumab - 60mg/ml 60mg/ml Injectable solution 21,603,638 L.L
C02KX01 PMS-BOSENTAN G Bosentan (monohydrate) - 62.5mg 62.5mg Tablet 77,539,821 L.L
N02BE01 PARANOR G Paracetamol - 650mg 650mg Tablet 162,605 L.L
V03AE07 PHOSPHOLOW G Calcium acetate - 660mg 660mg Tablet 1,118,077 L.L
N02BE01 PANADOL JOINT B Paracetamol - 665mg 665mg Tablet, film coated, prolonged release 291,614 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 2,822,386 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 663,077 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 7.5mg 7.5mg Tablet, film coated 1,890,786 L.L
R05DB21 PRIVITUSS G L-Cloperastine - 708mg/100ml 708mg/100ml Suspension 801,186 L.L
P02CB01 PIPERAZINE CITRATE G Piperazine citrate - 750mg/5ml 750mg/5ml Elixir 113,907 L.L
L01EF01 PALBRANCE 75 G Palbociclib - 75mg 75mg Capsule 168,011,222 L.L
L01EF01 PAPILLIO G Palbociclib - 75mg 75mg Capsule, hard 147,883,080 L.L
B01AC04 PLAVIX B Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 1,350,562 L.L
B01AC04 PLAVIX B Clopidogrel (hydrogenosulfate) - 75mg 75mg Tablet, film coated 1,350,562 L.L
B01AC04 PEDOVEX G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 808,993 L.L
B01AC04 PIDOGREL MEDIS G Clopidogrel - 75mg 75mg Tablet, film coated 810,337 L.L
N02BF02 PLENICA G Pregabalin - 75mg 75mg Capsule 697,454 L.L
N02BF02 PMS-PREGABALIN G Pregabalin - 75mg 75mg Capsule 1,776,560 L.L
N02BF02 PREGABADOR G Pregabalin - 75mg 75mg Capsule, hard 364,181 L.L
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