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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
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 189,615 L.L
B05XA03 SOLUFLEX SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45% 0.45% Injectable solution 176,974 L.L
C07BB07 BISCORDEX PLUS G Bisoprolol fumarate - 5mg, Hydrochlorothiazide - 12.5mg Tablet 723,115 L.L
C09DB01 POVAM G Amlodipine (besylate) - 5mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
G02AX GYNOCIN G Oxytocin - 10IU/ml 10IU/ml Injectable concentrate for solution 626,231 L.L
H02AB04 METHYLPREDNISOLONE ORBUCELL INJ. G Methylprednisolone sodium succinate - 125mg 125mg Injectable powder for solution 5,784,922 L.L
J02AC01 PANZIMOL G Fluconazole - 100mg 100mg Capsule, hard 2,015,764 L.L
L01BC05 GEMCITABINE NEAPOLIS G Gemcitabine (HCl) - 200mg 200mg Injectable powder for solution 1,490,321 L.L
M01AH05 CLINTON G Etoricoxib - 120mg 120mg Tablet, film coated 362,837 L.L
N02BE01 ADOL G Paracetamol - 500mg 500mg Suppository 131,697 L.L
N05AA01 CHLORPROMAZINE G Chlorpromazine HCl - 50mg 50mg Tablet 332,761 L.L
N06AX21 DULOXA 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
R03AK13 BUTOSOL G Salbutamol (sulfate) - 100mcg/dose, Beclometasone dipropionate - 50mcg/dose Metered dose inhaler 548,288 L.L
A03CA02 LIBROCOL G Chlordiazepoxide - 5mg, Clidinium bromide - 2.5mg Tablet 338,648 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 218,681 L.L
B05XA03 SODIUM CHLORIDE G Sodium chloride - 10% 10% Injectable solution 4,129,004 L.L
C07BB07 BISOCOR 5 PLUS G Bisoprolol - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 678,321 L.L
C09DB01 VIOSTAN AM 160/5 G Amlodipine besylate - 5mg, Valsartan - 160mg Tablet, film coated 1,177,206 L.L
D01BA01 GRISEOFULVIN G Griseofulvin - 500mg 500mg Tablet, scored 575,933 L.L
G02AX OXYTOCIN 10 PANPHARMA 10 UI-1ML G Oxytocin - 10IU/ml 10IU/ml Injectable solution 525,442 L.L
H02AB04 NEPHARED G Methylprednisolone sodium succinate - 125mg 125mg Injectable powder for solution 469,001 L.L
J02AC01 STABILANOL G Fluconazole - 100mg 100mg Capsule 1,432,331 L.L
L01BC05 GEMCITABINE THYMOORGAN G Gemcitabine (HCl) - 200mg 200mg Injectable powder for solution 1,617,986 L.L
M01AH05 CONSORT G Etoricoxib - 120mg 120mg Tablet, film coated 309,084 L.L
N02BE01 ALGIVIC G Paracetamol - 500mg 500mg Suppository 147,183 L.L
N05AB02 FLUPHENAZINE HCl G Fluphenazine (HCl) - 5mg 5mg Tablet, scored 624,567 L.L
N06AX21 LOXYT 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
A03CA02 PRIMAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
A10BB09 LOWZID XR G Gliclazide - 60mg 60mg Tablet, extended release 309,724 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.02g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 239,275 L.L
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