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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
B05BB02 SOLUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.45% INJECTION, USP G Sodium chloride - 0.45%, Glucose - 5% Injectable solution 211,449 L.L
C01CA24 ADRENALINE RENAUDIN G Epinephrine (tartrate) - 1mg/ml 1mg Injectable solution 444,812 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 120mg 120mg Capsule, controlled release 517,059 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,067,011 L.L
D06AA04 MEPHICYCLINE DERMIQUE G Tetracycline HCl - 3% 3% Ointment 145,903 L.L
J01DH02 AROPEM G Meropenem - 0.5g 0.5g Injectable powder for solution 995,723 L.L
J05AB01 CYCLOVEX G Aciclovir - 400mg 400mg Tablet, scored 2,687,685 L.L
L01XA03 OXALIPLATIN HOSPIRA G Oxaliplatin - 100mg/20ml 5mg/ml Injectable concentrated solution 8,471,583 L.L
L04AX04 LENALIDOMIDE SPC G Lenalidomide - 5mg 5mg Capsule, hard 71,647,217 L.L
N02BF02 GABRIKA 75 G Pregabalin - 75mg 75mg Capsule 793,507 L.L
N05AX08 RESPAL 1 G Risperidone - 1mg 1mg Caplet, film coated 309,084 L.L
N07AA01 METHYL SULFATE DE NEOSTIGMINE RENAUDIN G Neostigmine methyl sulfate - 0.5mg/ml 0.5mg/ml Injectable solution 467,657 L.L
R05C SULDEX G Caffein anyhdrous - 0.216g, Antipyrine - 0.972g, Potassium sulfaguaiacolate - 1.44g Syrup 152,302 L.L
L04AA31 TERAGIO G Teriflunomide - 14mg 14mg Tablet L.L
A04AA01 ONDANSETRON ARROW G Ondansetron - 8mg 8mg Tablet, orodispersible 1,280,682 L.L
B01AC06 A.S HEART G Acetylsalicylic acid - 81mg 81mg Tablet, enteric coated 148,463 L.L
B05BB02 2.5% DEXTROSE 0.45% SODIUM CHLORIDE INJECTION G Dextrose,H2O - 2.5g/100ml, Sodium chloride - 0.45g/100ml Injectable solution 172,377 L.L
C01CA24 ADRENALINE SALF G Adrenaline - 1mg/ml 1mg/ml Injectable solution 220,390 L.L
D06AA04 TETRACYCLINE OINTMENT G Tetracycline HCl - 3% 3% Ointment 107,507 L.L
J01DH02 AROPEM G Meropenem - 0.5g 0.5g Injectable powder for solution 19,022,727 L.L
J05AB01 VICLORIX 400 G Aciclovir - 400mg 400mg Tablet 3,589,851 L.L
L01XA03 OXALIPLATIN MEDAC G Oxaliplatin - 100mg 100mg Injectable powder for solution 7,841,801 L.L
L04AX04 LENALIDOMIDE STRAGEN G Lenalidomide - 5mg 5mg Capsule 33,314,752 L.L
M04AA03 FEBUXOSTAT ARROW G Febuxostat - 120mg 120mg Tablet, film coated 1,084,481 L.L
N02BF02 GALICA 75 G Pregabalin - 75mg 75mg Capsule 338,648 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 1mg 1mg Tablet, coated, scored 643,701 L.L
N07AA01 NEOSTIGMINE RENAUDIN G Neostigmine - 5mg/5ml 5mg/5ml Injectable solution 2,460,576 L.L
R05CA ASPECTON COUGH SYRUP G Thyme soft extract - 6.69g/100ml Syrup 588,603 L.L
L01CB01 ETOPOSIDE VIATRIS 20MG/ML G Etoposide - 100mg/5ml 100mg/5ml Injectable concentrated solution L.L
A04AA01 ONZETRAN OD G Ondansetron - 8mg 8mg Tablet, orodispersible 1,023,880 L.L
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