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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
N06AB10 ZELAX 10 G Escitalopram (oxalate) - 10mg 10mg Caplet 833,182 L.L
R03AC02 RONKOTOL G Salbutamol (sulfate) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 470,345 L.L
L01EF01 PAPILLIO G Palbociclib - 125mg 125mg Capsule, hard L.L
A10BA02 DIALON G Metformin HCl - 850mg 850mg Tablet 98,101 L.L
A12AA03 10% W/V CALCIUM GLUCONATE INJECTION BP G Calcium gluconate - 10% 10% Injectable solution 3,952,241 L.L
B05XA03 SODIUM CHLORIDE G Sodium chloride - 0.9% 0.9% Injectable solution 209,151 L.L
C07AB07 BISCORDEX G Bisoprolol fumarate - 10mg 10mg Tablet 789,667 L.L
D11AX18 DILO G Diclofenac sodium - 8% 8% Spray 502,981 L.L
H01BB03 CARBETOCINA GP-PHARM G Carbetocin - 100mcg 100mcg Injectable solution 9,041,227 L.L
J01DD04 LEBACEF G Ceftriaxone (sodium) - 1g 1g Injectable powder for solution+diluent 508,100 L.L
L01AX03 TEMOZOLOMIDE PHARMINICIO G Temozolomide - 5mg 5mg Capsule, hard 1,153,017 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet 23,076,914 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 875,417 L.L
R03AC02 SALBUTAMOL SULFATE G Salbutamol (sulfate) - 2mg 2mg Tablet, scored 401,873 L.L
A03AA04 SPASMINE (Mebeverine HCl 200mg SR) G Mebeverine HCl - 200mg 200mg Capsule, slow release 712,876 L.L
A10BA02 DIANORM 850 G Metformin HCl - 850mg 850mg Tablet, film coated 221,286 L.L
A12AA03 CALCIUM GLUCONATE G Calcium gluconate - 10g/100ml 10g/100ml Injectable solution 763,056 L.L
B05XA03 SODIUM CHLORIDE G Sodium chloride - 0.9% 0.9% Injectable solution 222,941 L.L
C07AB07 BISOCOR 10 G Bisoprolol fumarate - 10mg 10mg Tablet, film coated 460,746 L.L
C10BA05 OTOREZA 10MG/40MG G Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 1,144,954 L.L
J01DD04 LEBACEF G Ceftriaxone - 1g 1g Injectable sterile powder for solution + lidocaine solvent 508,100 L.L
J01XA02 TEICO MEDIS 200 G Teicoplanin - 200mg 200mg Injectable lyophilised powder 428,686 L.L
L01AX04 DACARBAZINE MEDAC G Dacarbazine - 200mg 200mg Injectable powder for solution 15,866,076 L.L
M01AE51 FLUMIX BENTA G Ibuprofen - 200mg, Guaifenesin - 200mg, Chlorpheniramine maleate - 2mg, Phenylephrine HCl - 5mg Tablet, film coated 460,746 L.L
N06AB10 CITOXAL G Escitalopram (oxalate) - 15mg 15mg Tablet, film coated 2,166,786 L.L
R03AC13 AEROFOR G Formoterol fumarate - 12mcg 12mcg Capsule, inhalation 897,687 L.L
R06AX27 AERIALLERG G Desloratadine - 5mg 5mg Tablet, film coated 400,465 L.L
A03AA04 BEVACOL 135 G Mebeverine HCl - 135mg 135mg Tablet, film coated 532,162 L.L
A10BA02 DIANORM 850 G Metformin HCl - 850mg 850mg Tablet, film coated 221,286 L.L
A12AA03 CALCIUM GLUCONATE G Calcium gluconate - 10g/100ml 10g/100ml Injectable solution 6,867,500 L.L
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