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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
M01AB05 DIVIDO 75MG B Diclofenac sodium - 75mg 75mg Capsule, dual release 502,597 L.L
A02BC01 OMEPRAL G Omeprazole - 20mg 20mg Capsule, delayed release 213,735 L.L
A02BC01 OMEPRAL G Omeprazole - 40mg 40mg Capsule, delayed release 499,142 L.L
A02BC03 LPZ-30 G Lansoprazole - 30mg 30mg Capsule, delayed release 360,150 L.L
A02BC05 EXONAR G Esomeprazole (magnesium trihydrate) - 20mg 20mg Capsule, delayed release 511,940 L.L
A02BC05 EXONAR G Esomeprazole (magnesium trihydrate) - 40mg 40mg Capsule, delayed release 639,925 L.L
A02BC06 DEXILANT B Dexlansoprazole - 30mg 30mg Capsule, delayed release 1,595,141 L.L
A02BC06 DEXILANT B Dexlansoprazole - 60mg 60mg Capsule, delayed release 2,375,914 L.L
A03AX COLPERMIN B Pepermint oil - 187mg 187mg Capsule, delayed release 632,950 L.L
N06AX21 DULOXA 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
N06AX21 LOXYT 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 60mg 60mg Capsule, delayed release 976,973 L.L
N06AX21 DULOXA 30 G Duloxetine HCl - 30mg 30mg Capsule, delayed release 716,716 L.L
N06AX21 LOXYT 30 G Duloxetine HCl - 30mg 30mg Capsule, delayed release 716,716 L.L
N06AX21 PMS-DULOXETINE G Duloxetine HCl - 30mg 30mg Capsule, delayed release 642,357 L.L
L04AX07 TECFEO 240 G Dimethyl Fumarate - 240mg 240mg Capsule, delayed release L.L
L04AX07 TECFEO 240 G Dimethyl Fumarate - 240mg 240mg Capsule, delayed release 67,784,092 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 180mg 180mg Capsule, controlled release 966,287 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 120mg 120mg Capsule, controlled release 517,059 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 240mg 240mg Capsule, controlled release 1,002,123 L.L
J01CA04 AMOXYCILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 4,073,187 L.L
J05AH02 TAMIFLU B Oseltamivir (phosphate) - 75mg 75mg Capsule 1,464,788 L.L
J01CA04 MOXILEN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 3,717,068 L.L
J05AH02 FLUMIVIR G Oseltamivir - 75mg 75mg Capsule 1,384,158 L.L
L01XX35 ANAGRELIDE BIOGARAN G Anagrelide - 0.5mg 0.5mg Capsule 15,754,068 L.L
J05AH02 VIRIFLU G Oseltamivir - 75mg 75mg Capsule 1,371,615 L.L
M09AX NUCLEO C.M.P. FORTE G UTP+UDP+UMP - 3mg, CMP - 5mg Capsule 448,843 L.L
R05X COLDIN G Caffeine - 30mg, Noscapine - 10mg, Pseudoephedrine HCl - 30mg, Pyrilamine maleate (Mepyramine) - 15mg, Paracetamol - 300mg Capsule 386,515 L.L
J01FA10 ZITHROMAX B Azithromycin (dihydrate) - 250mg 250mg Capsule 591,291 L.L
R05X COLD-MED G Caffeine - 30mg, Noscapine - 10mg, Pseudoephedrine HCl - 30mg, Pyrilamine Maleate (Mepyramine) - 15mg, Paracetamol - 300mg Capsule 386,515 L.L
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