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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
C02KX01 BOSENTAN ARROW G Bosentan (monohydrate) - 125mg 125mg Tablet, film coated L.L
A03FA03 NOVADOM G Domperidone - 10mg 10mg Tablet 278,175 L.L
A10BB12 GLYPRIDE G Glimepiride - 3mg 3mg Tablet 571,133 L.L
B05BB02 5% DEXTROSE 0.9% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 5g/100ml, Sodium chloride - 0.9g/100ml Injectable solution 180,421 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS LS2 G Potassium chloride - K+:1.5 mmol/l, Magnesium chloride - Mg++:0.75 mmol/l, Calcium chloride - Ca++:1.5 mmol/l, Sodium acetate - Cl-:111 mmol/l, Sodium chloride - Na+:140 mmol/l Injectable solution L.L
C08CA01 LOTENSE G Amlodipine (besylate) - 5mg 5mg Capsule 388,370 L.L
C09DB06 LOSANET AM G Losartan potassium - 100mg, Amlodipine - 10mg Tablet 1,044,358 L.L
D03BA SERODASE G Serratiopeptidase - 5mg 5mg Tablet, enteric coated 460,938 L.L
H02AB08 TRIACORT G Triamcinolone acetonide - 40mg/ml 40mg/ml Injectable suspension 745,833 L.L
J02AC02 TRACON G Itraconazole - 100mg 100mg Capsule 559,038 L.L
N02BE01 STOPALGIC G Paracetamol - 1g/100ml 1g/100ml Injectable solution 1,536,012 L.L
N05AH03 OLANZAPINE ARROW G Olanzapine - 5mg 5mg Tablet 670,577 L.L
R03BA02 AERONIDE G Budesonide - 400mcg 400mcg Capsule, inhalation 2,116,552 L.L
A03FA03 PROKININ G Domperidone - 10mg 10mg Tablet, film coated 221,734 L.L
A10BB12 JOSWE GLEMAX 3 G Glimepiride - 3mg 3mg Caplet 235,172 L.L
B05BB02 5% DEXTROSE 0.9% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 5g/100ml, Sodium chloride - 0.9g/100ml Injectable solution 226,388 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS LS3 G Potassium chloride - K+:2.00 mmol/l, Magnesium chloride - Mg++:0.75 mmol/l, Calcium chloride - Ca++:1.60 mmol/l, Sodium acetate - Cl-:112 mmol/l, Sodium chloride - Na+:140 mmol/l Injectable solution L.L
C08CA01 LOWRAC 5 G Amlodipine (besylate) - 5mg 5mg Capsule 362,837 L.L
C09DB06 LOSANET AM G Losartan potassium - 100mg, Amlodipine - 5mg Tablet 1,044,358 L.L
G03AD01 EZ-ONE G Levonorgestrel - 1.5mg 1.5mg Tablet 722,987 L.L
H02AB09 HYDROCORTISON VUAB G Hydrocortisone hydrogenosuccinate - 100mg 100mg Injectable dry powder for solution 147,823 L.L
J02AC03 VORICONAZOLE STRAGEN G Voriconazole - 50mg 50mg Tablet, coated 15,808,184 L.L
L01BC07 AZACITIDINE ARROW G Azacitidine - 25mg/ml 25mg/ml Injectable suspension 10,967,854 L.L
N02BE01 PARACETAMOL B.BRAUN G Paracetamol - 1000mg/100ml 1000mg/100ml Injectable solution 129,009 L.L
N05AH03 PREXAL 5 G Olanzapine - 5mg 5mg Caplet, film coated 718,956 L.L
N06BA07 MODAFINIL ARROW G Modafinil - 100mg 100mg Tablet 5,361,932 L.L
A10BB12 ORBIDE G Glimepiride - 3mg 3mg Tablet 351,959 L.L
B05BB02 5% DEXTROSE 0.9% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 5g/100ml, Sodium chloride - 0.9g/100ml Injectable solution 153,990 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS R G Potassium chloride - K+:1.00 mmol/l, Magnesium chloride - Mg++:0.75 mmol/l, Calcium chloride - Ca++:1.40 mmol/l, Sodium acetate - Cl-:105.8 mmol/l, Sodium chloride - Na+:140.5 mmol/l Injectable solution L.L
C08CA01 LUSTRA G Amlodipine - 5mg 5mg Tablet 485,127 L.L
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