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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 DEXTROSE 2.5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 2.5g/100ml Injectable solution 176,974 L.L
C01CA26 EPHEDRINE RENAUDIN G Ephedrine HCl - 30mg/ml 3% Injectable solution 693,423 L.L
C09AA01 APO-CAPTO G Captopril - 25mg 25mg Tablet, scored 1,132,859 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 20mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,037,446 L.L
D06AX DERMOTRACIN G Neomycin sulfate - 165.000IU/150ml, Bacitracin - 15.500IU/150ml Powder 737,770 L.L
G03DA04 DARSTIN G Progesterone - 10mg/g 10mg/g Gel 380,307 L.L
J01DH02 AROPEM G Meropenem (trihydrate) - 1g 1g Injectable powder for solution 995,723 L.L
L01CD02 DOCETAXEL GP PHARM G Docetaxel - 40mg/ml 80mg/2ml Injectable concentrated solution+diluent 16,777,239 L.L
L01XA03 OXALTIE G Oxaliplatin - 100mg 100mg Injectable lyophilised powder for solution 5,915,595 L.L
M04AA03 STABURIC G Febuxostat - 120mg 120mg Tablet, film coated 1,420,889 L.L
N02BF02 NEUREXAL G Pregabalin - 75mg 75mg Capsule 637,365 L.L
N05AX08 DEPIA ORAL SOLUTION G Risperidone - 1mg/ml 1mg/ml Solution 1,510,223 L.L
N07BB03 ACAMPROSATE BIOGARAN G Acamprosate - 333mg 333mg Tablet, gastroresistant 3,641,813 L.L
R05CA12 LIBLAB COUGH SUPPOSITORIES G Dried Ivy leaf extract - 80mg 80mg Suppository 142,447 L.L
A04AA01 NAUSETRON G Ondansetron - 4mg/5ml 4mg/5ml Solution 802,466 L.L
A10BD07 SITAMET G Metformin - 850mg, Sitagliptin - 50mg Tablet, film coated 2,392,203 L.L
B05BB02 DEXTROSE 2.5% & SODIUM CHLORIDE 0.45% G Sodium chloride - 0.45g/100ml, Dextrose, H2O - 2.5g/100ml Injectable solution 198,578 L.L
C01CA26 EPHEDRINE AGUETTANT G Ephedrine HCl - 3mg/ml 3mg/ml Injectable solution 7,827,491 L.L
C09AA01 CAPTACE G Captopril - 25mg 25mg Tablet, scored 486,343 L.L
D06AX PENICILLIN DERMIC OINTMENT G Penicillin - 5,000IU 5,000IU Ointment 80,631 L.L
J01AA02 DOXY 50 G Doxycycline (hyclate) - 50mg 50mg Tablet, coated 311,771 L.L
J01DH02 AROPEM G Meropenem - 1g 1g Injectable powder for solution 995,723 L.L
L01CD02 DOCETAXEL SPC G Docetaxel - 80mg/4ml 80mg/4ml Injectable concentrate for solution 16,906,027 L.L
L04AX04 LEDOBOOK 10 G Lenalidomide - 10mg 10mg Capsule 62,230,245 L.L
N02BF02 PLENICA G Pregabalin - 75mg 75mg Capsule 697,454 L.L
N05AX08 PMS-RISPERIDONE G Risperidone - 1mg/ml 1mg/ml Solution 604,729 L.L
N07BC01 BUPENSAN G Buprenorphine - 8mg 8mg Tablet 1,259,180 L.L
S01GX09 CONJYCLEAR G Olopatadine (HCl) - 0.1% 0.1% Drops solution 510,660 L.L
A04AA01 ONDEMED G Ondansetron (HCl) - 4mg/5ml 4mg/5ml Solution 858,779 L.L
A10BD07 SITAVITEA PLUS G Metformin - 850mg, Sitagliptin - 50mg Tablet, film coated 1,079,106 L.L
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