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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
C01BC04 FLECAINIDE ARROW LAB G Flecainide acetate - 100mg 100mg Tablet, scored 588,603 L.L
C08CA01 NIPIDOL G Amlodipine - 10mg 10mg Tablet 377,620 L.L
C09DX01 VIOSTAN AM PLUS 160/5/25 G Valsartan - 160mg, Amlodipine - 5mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,196,020 L.L
J02AX04 CASPOFUNGINE STRAGEN G Caspofungin (acetate) - 70mg 70mg Injectable concentrated powder for solution 22,928,852 L.L
L01CA02 CELLCRISTIN G Vincristine sulfate - 1mg/ml 1mg/ml Injectable solution 1,443,287 L.L
M03AC11 SISACURE G Cisatracurium (besylate) - 20mg/10ml 20mg/10ml Injectable solution 1,408,347 L.L
N02BE01 PARA-SOLUTIONS G Paracetamol - 1g/100ml 500mg/100ml Injectable solution 179,179 L.L
N06BX06 TRAUSAN G Citicoline - 100mg/ml 100mg/ml Drops solution 807,649 L.L
R03BB04 NEUMOTROPIO G Tiotropium bromide - 10mcg 10mcg Capsule, inhalation 3,115,844 L.L
S01CA01 OPTIDEX T G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 266,081 L.L
A04AA01 NAUSETRON G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, scored 1,023,880 L.L
A10BD02 GLYSTOR PLUS G Metformin HCl - 500mg, Glibenclamide - 2.5mg Tablet, film-scored 533,697 L.L
B05BB02 SERUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 194,211 L.L
C01BC04 FLECAINIDE BIOGARAN L.P. G Flecainide acetate - 100mg 100mg Capsule, extended release 1,154,361 L.L
C08CA01 TORANS G Amlodipine (besylate) - 10mg 10mg Tablet 716,716 L.L
D04AX01 DOXIDERM G Doxepin (HCl) - 5% 5% Cream 1,037,958 L.L
J01DE01 CEFIPEX 500 BENTA G Cefepime (hydrochloride) - 500mg 500mg Injectable solution 545,216 L.L
L01CA04 EBERELBIN G Vinorelbine (tartrate) - 50mg/5ml 50mg/5ml Injectable concentrated solution 6,834,783 L.L
N02BE01 SUPOFEN G Paracetamol - 10mg/ml 10mg/ml Injectable solution 7,675,286 L.L
N05AH03 APO-OLANZAPINE ODT G Olanzapine - 10mg 10mg Tablet, orally disintegrating 2,422,948 L.L
L01EF01 PAPILLIO G Palbociclib - 100mg 100mg Capsule, hard L.L
A04AA01 NOZENTRIX G Ondansetron - 8mg 8mg Tablet, film coated 1,151,865 L.L
B01AC04 AGGRIX 75 G Clopidogrel besylate - 75mg 75mg Tablet, film coated 1,204,083 L.L
B05BB02 SERUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 180,421 L.L
C01BC04 FLECAINIDE BIOGARAN L.P. G Flecainide acetate - 50mg 50mg Capsule, extended release 1,154,361 L.L
C08CA04 NICARDIPINE ARROW G Nicardipine chlorhydrate - 10mg/10ml 10mg/10ml Injectable solution 2,590,928 L.L
C09DX01 LOTEVAN PLUS G Valsartan - 160mg, Amlodipine - 10mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 911,125 L.L
D05AA ICHTAMMOL OINTMENT G Tars - 10% 10% Ointment 90,869 L.L
J01DE01 CEFEPIME LDP LABORATORIOS TORLAN G Cefepime - 1g 1g Injectable powder for solution 5,933,065 L.L
J02AX04 CANDIGARD G Caspofungin (acetate) - 50mg 50mg Injectable powder for concentrate for solution 22,127,179 L.L
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