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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
J01DD13 CEFPODOXIME ARROW LAB G Cefpodoxime (proxetil) - 100mg 100mg Tablet, film coated 499,909 L.L
N06DA02 DONECEPT 10 G Donepezil HCl - 10mg 10mg Tablet, film coated 2,292,595 L.L
N02BE51 PANADOL EXTRA WITH OPTIZORB B Paracetamol - 500mg, Caffeine - 65mg Tablet, film coated 524,099 L.L
N06DA02 DONEPEZIL ARROW G Donepezil HCl - 10mg 10mg Tablet, film coated 1,365,344 L.L
G03AA12 YASMIN B Drospirenone - 3mg, Ethinylestradiol - 30mcg Tablet, film coated 616,824 L.L
N02BE51 PANADOL EXTRA WITH OPTIZORB B Paracetamol - 500mg, Caffeine - 65mg Tablet, film coated 252,642 L.L
R03DC03 SINGULAIR B Montelukast (sodium) - 10mg 10mg Tablet, film coated 1,248,430 L.L
N02BE51 DIFEN GESIC G Paracetamol - 400mg, Diclofenac potassium - 50mg Tablet, film coated 330,585 L.L
N06DA02 DOPEZIL G Donepezil HCl - 10mg 10mg Tablet, film coated 1,381,470 L.L
R03DC03 AIRFAST G Montelukast (sodium) - 10mg 10mg Tablet, film coated 802,274 L.L
G03AA12 YAZ B Drospirenone - 3mg, Ethinylestradiol - 20mcg Tablet, film coated 1,193,332 L.L
M03BA53 FLEXPRO EXTRA G Paracetamol - 500mg, Methocarbamol - 400mg Tablet, film coated 337,304 L.L
N05AH04 QUETIAPINE/ GENEPHARM G Quetiapine - 25mg 25mg Tablet, film coated 712,237 L.L
A03FA07 GAROPRIDE G Itopride Hydrochloride - 50mg 50mg Tablet, film coated 213,671 L.L
J02AC03 VFEND B Voriconazole - 200mg 200mg Tablet, film coated 51,904,550 L.L
N05AH04 SEROPINE 25 G Quetiapine fumarate - 25mg 25mg Tablet, film coated 1,233,647 L.L
R03DC03 LUKAST G Montelukast (sodium) - 10mg 10mg Tablet, film coated 802,274 L.L
J02AC03 VIROZOLE 200 G Voriconazole - 200mg 200mg Tablet, film coated 47,909,207 L.L
R03DC03 MONTELUKAST ARROW LAB G Montelukast (sodium) - 10mg 10mg Tablet, film coated 978,317 L.L
C01BC03 RYTMONORM B Propafenone HCl - 150mg 150mg Tablet, film coated 1,119,850 L.L
G03AC09 CERAZETTE B Desogestrel - 75mcg 75mcg Tablet, film coated 407,184 L.L
N02BE51 A.B.C.-COLD G Paracetamol - 500mg, Chlorphenamine maleate - 4mg, Phenylephrine HCl - 5mg Tablet, film coated 534,977 L.L
N05AH04 QUETIAPINE/ GENEPHARM G Quetiapine - 100mg 100mg Tablet, film coated 1,569,608 L.L
R03DC03 MONTELUKAST-SANDOZ G Montelukast (sodium) - 10mg 10mg Tablet, film coated 1,136,296 L.L
A04AA01 ZOFRAN B Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, film coated 6,329,648 L.L
C01BC03 RYTMONORM B Propafenone HCl - 300mg 300mg Tablet, film coated 1,883,860 L.L
G03AD01 PURPLE LINE G Levonorgestrel - 1.5mg 1.5mg Tablet, film coated 1,071,570 L.L
L01BC59 LONSURF B Trifluridine - 20mg, Tipiracil - 8.19mg Tablet, film coated 75,019,126 L.L
N02BE51 RHINOSTOP G Paracetamol - 500mg, Chlorphenamine maleate - 4mg, Phenylephrine HCl - 5mg Tablet, film coated 534,977 L.L
N05AH04 SEROPINE 100 G Quetiapine fumarate - 100mg 100mg Tablet, film coated 1,996,950 L.L
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