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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
L01XA03 OXALIPLATIN HOSPIRA G Oxaliplatin - 50mg/10ml 5mg/ml Injectable concentrated solution 3,450,988 L.L
N03AB02 α PHENYTOIN SODIUM 5% USP G Phenytoin (sodium) - 250mg/5ml 5ml Injectable solution 276,448 L.L
P02CA03 ANDAZOL G Albendazole - 200mg 6 Tablet, film coated 302,365 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 6 Billions/2g 6 billions/2g Powder for suspension 1,493,009 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 6 Billions/2g 6 billions/2g Powder for suspension 1,343,843 L.L
B05AA07 VOLUVEN B Starch poly(O-2-Hydroxyethyl) - 6% 6% Injectable solution 987,724 L.L
B01AB05 ENOXA MEDIS BioTech Enoxaparin sodium - 6,000U Anti-Xa/0.6ml 6,000U Anti-Xa/0.6ml Injectable solution 765,990 L.L
C07AG02 DILATREND B Carvedilol - 6.25mg 6.25mg Tablet, scored 364,181 L.L
C07AG02 CARVEDILOL ARROW G Carvedilol - 6.25mg 6.25mg Tablet, film coated, scored 364,181 L.L
A06AD11 DUPHALAC B Lactulose - 6.7g/10ml 6.7g/10ml Solution 454,219 L.L
B01AB05 PARINOX 60 BioTech Enoxaparin sodium - 6000IU (60mg)/0.6ml 6000IU (60mg)/0.6ml Injectable solution 438,989 L.L
B01AB05 ENOXAMED BioTech Enoxaparin sodium - 6000IU Anti-XA/0.6ml 6000IU Anti-XA/0.6ml Injectable solution 765,990 L.L
B01AB05 ENOXAMED BioTech Enoxaparin sodium - 6000IU Anti-XA/0.6ml 6000IU Anti-XA/0.6ml Injectable solution 3,637,782 L.L
B01AB05 ENOMEX BioTech Enoxaparin sodium - 6000U Anti-Xa/0.6ml 6000U Anti-Xa/0.6ml Injectable solution 922,772 L.L
B01AB05 ENOXAPARIN LEDRAXEN BioTech Enoxaparin sodium - 6000UI (60mg)/0.6ml 6000UI (60mg)/0.6ml Injectable solution 854,684 L.L
B01AB05 LOVENOX BioTech Enoxaparin sodium - 6000UI (60mg)/0.6ml 6000UI (60mg)/0.6ml Injectable solution 1,085,825 L.L
B02BD04 IMMUNINE BioHuman Plasma coagulation factor IX, human - 600IU 600IU Injectable lyophilised powder for solution+diluent 20,506,214 L.L
G03GA02 MENOPUR BioHuman Menotropin - 600IU 600IU Injectable powder for solution+diluent 13,907,829 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 24,121,923 L.L
G03GA06 PUREGON BioHuman Follitropin beta - 600IU/0.72ml 600IU/0.72ml Injectable solution 24,121,923 L.L
B01AC27 UPTRAVI B Selexipag - 600mcg 600mcg Tablet, film coated 275,097,581 L.L
N03AF01 NEUROTOP RETARD G Carbamazepine - 600mg 600mg Tablet, prolonged release 1,569,608 L.L
J01CR02 MEGAMOX-JPI ES G Amoxicillin (trihydrate) - 600mg/5ml, Clavulanic Acid (potassium) - 42.9mg/5ml 600mg Powder for suspension 507,972 L.L
N03AX12 GABATREX G Gabapentin - 600mg 600mg Tablet 3,132,497 L.L
M01AE01 BRUFEN B Ibuprofen - 600mg 600mg Tablet, film coated 423,121 L.L
M01AE01 PROFINAL G Ibuprofen - 600mg 600mg Tablet 302,365 L.L
C05CA03 DIOVENOR 600 B Diosmin - 600mg 600mg Tablet, film coated 1,089,856 L.L
C05CA03 DIOVENOR 600 B Diosmin - 600mg 600mg Tablet 544,256 L.L
C05CA03 DIOSMINE BIOGARAN CONSEIL G Diosmin - 600mg 600mg Tablet, coated 761,959 L.L
C10AB04 LOPID B Gemfibrozil - 600mg 600mg Tablet, film coated 498,566 L.L
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