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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
R02A MAXILASE MAUX DE GORGE B Alpha-Amylase - 200U.CEIP/ml 200U.CEIP/ml Syrup 342,680 L.L
R02A ALFA-AMYLASE BGR CONSEIL G Alpha-Amylase - 200U.CEIP/ml 200U.CEIP/ml Syrup 384,339 L.L
R02A ANGINOVAG G Lidocaine HCl - 100mg/100ml, Hydrocortisone acetate - 60mg/100ml, Tyrothricin - 400mg/100ml, Dequalinium chloride - 100mg/100ml, ?-Glycerrhetinic acid - 60mg/100ml Spray 651,764 L.L
R02A TRACHISAN G Lidocaine HCl - 1mg, Tyrothricin - 0.5mg, Chlorhexidine gluconate - 1mg Lozenge 228,453 L.L
R02A CHLORASEPTIC TOTAL SORE THROAT + COUGH LOZENGES WILD CHERRY G Benzocaine - 6mg, Dextromethorphan - 5mg, Menthol - 10mg Lozenge 537,537 L.L
R02AA05 GOLASEPTINE-LIDOCAINE G Chlorhexidine HCl - 5mg, Lidocaine HCl - 1mg Tablet, chewable 736,426 L.L
R02AA20 HEXASPRAY COLLUTOIRE PRESSURISE B Biclotymol - 750mg 750mg Spray 353,431 L.L
R03AC02 VENTOLIN EVOHALER B Salbutamol (sulfate) - 100mcg/dose 100mcg/dose Inhalation aerosol metered dose 260,705 L.L
R03AC02 BUTALIN G Salbutamol (sulfate) - 100mcg/dose 100mcg/dose Inhalation aerosol metered dose 145,135 L.L
R03AC02 BUTO-ASMA G Salbutamol - 100mcg 100mcg Inhalation 237,860 L.L
R03AC02 VENTOLIN B Salbutamol (sulfate) - 5mg/ml 5mg/ml Solution 403,153 L.L
R03AC02 ASMALAT G Salbutamol (sulfate) - 2mg/5ml 2mg/5ml Syrup 177,899 L.L
R03AC02 BUTALIN G Salbutamol (sulfate) - 2mg/5ml 2mg/5ml Syrup, sugar free 122,290 L.L
R03AC02 ASTHALIN G Salbutamol (sulfate) - 2.5mg/2.5ml 2.5mg/2.5ml Inhalation solution 325,210 L.L
R03AC02 SALBUTAMOL SULFATE G Salbutamol (sulfate) - 2mg 2mg Tablet, scored 401,873 L.L
R03AC18 ONBREZ BREEZHALER B Indacaterol maleate - 150mcg 150mcg Capsule, inhalation 2,284,532 L.L
R03AK06 SERETIDE DISKUS 100 B Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 100mcg/inhalation Inhalation powder 2,276,469 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 100mcg Capsule, inhalation 1,777,706 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 100mcg/dose Inhalation powder 1,593,797 L.L
R03AK06 SERETIDE DISKUS 250 B Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation powder 2,830,132 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 250mcg Capsule, inhalation 2,487,891 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 250mcg/dose Inhalation powder 1,980,824 L.L
R03AK06 SERETIDE DISKUS 500 B Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 500mcg/inhalation Inhalation powder 3,199,689 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 500mcg Capsule, inhalation 3,169,668 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 500mcg/dose Inhalation powder 2,605,711 L.L
R03AK06 SEROFLO 500 G Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 500mcg/inhalation Inhalation suspension 2,031,890 L.L
R03AK06 SEROFLO-S 125 G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 125mcg/inhalation Inhalation suspension 1,212,146 L.L
R03AK06 CYVAX G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,710,712 L.L
R03AK06 SEROFLO 250 G Salmeterol (xinafoate) - 50mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,580,359 L.L
R03AK06 SEROFLO-S 250 G Salmeterol (xinafoate) - 25mcg/inhalation, Fluticasone propionate - 250mcg/inhalation Inhalation suspension 1,725,494 L.L
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