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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
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 25mg Tablet, film coated 628,918 L.L
S01CA01 CO-AVAZIR G Tobramycin - 0.3%, Dexamethasone - 0.1% Drops suspension 193,513 L.L
A03CA02 BIPAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet, sugar coated 363,477 L.L
B05BB01 RINGER'S INJECTION USP G Calcium chloride, 2H2O - 0.033%, Potassium chloride - 0.03%, Sodium chloride - 0.86% Injectable solution 199,957 L.L
C07BB03 TENORETIC B Chlortalidone - 25mg, Atenolol - 100mg Tablet, film coated 291,614 L.L
C09DA08 VOTUM PLUS B Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 900,374 L.L
S01CA01 DEXATOBRIN G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 239,204 L.L
A03CA02 LIBROCOL G Chlordiazepoxide - 5mg, Clidinium bromide - 2.5mg Tablet 338,648 L.L
B05BB01 RINGER'S INJECTION, USP G Calcium chloride, 2H2O - 0.33g/l, Potassium chloride - 0.3g/l, Sodium chloride - 8.6g/l Injectable solution 189,615 L.L
C07BB03 ATONIUM PLUS G Chlortalidone - 25mg, Atenolol - 100mg Tablet 738,473 L.L
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 628,918 L.L
G01AF20 MICOGYL G Metronidazole - 500mg, Miconazole nitrate - 100mg Suppository 362,198 L.L
S01CA01 OPTIDEX T G Dexamethasone - 1mg/ml, Tobramycin - 3mg/ml Drops suspension 266,081 L.L
A03CA02 PRIMAX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 218,681 L.L
C07BB07 CONCOR PLUS B Bisoprolol fumarate - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 888,105 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 12.5mg Tablet, film coated 1,846,440 L.L
G01AX OVUMIX G Metronidazole - 300mg, Miconazole - 100mg, Neomycin (sulfate) - 48.8mg, Gotu Kola - 15mg, Polymixin sulfate - 4.4mg Suppository 395,090 L.L
M02AA15 GROFENAC G Diclofenac sodium - 1% Emulsion Gel 314,459 L.L
S01CA01 FRAKIDEX B Dexamethasone disodium phosphate - 0.1g/100g, Framycetin sulfate - 0.5g/100g Ointment 141,103 L.L
A03CA02 ULCEDEX G Clidinium bromide - 2.5mg, Chlordiazepoxide - 5mg Tablet 222,694 L.L
B05BB01 LACTATED RINGER'S G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.02g/100ml, Sodium chloride - 0.598g/100ml Injectable solution 239,275 L.L
C07BB07 BISCORDEX PLUS G Bisoprolol fumarate - 5mg, Hydrochlorothiazide - 12.5mg Tablet 723,115 L.L
C09DA09 EDARBYCLOR B Azilsartan medoxomil - 40mg, Chlortalidone - 25mg Tablet, film coated 1,846,440 L.L
G01AX ENTEROGERMINA B Bacillus clausii spores - 2 Billions/5ml Suspension 1,131,515 L.L
S01CA01 API-TOBRASON G Dexamethasone - 1mg/g, Tobramycin - 3mg/g Ointment 243,235 L.L
A03CB01 RESTROPINAL PEDIATRIC B Butobarbital - 2mg/ml, Methyl hyoscine nitrate - 0.1mg/ml Drops 197,097 L.L
B05BB01 LACTATED RINGER'S INJECTION USP G Sodium lactate - 0.31g/100ml, Calcium chloride, 2H2O - 0.02g/100ml, Potassium chloride - 0.03g/100ml, Sodium chloride - 0.6g/100ml Injectable solution 197,659 L.L
C07BB07 BISOCOR 5 PLUS G Bisoprolol - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 678,321 L.L
C09DB01 EXFORGE B Amlodipine - 5mg, Valsartan - 160mg Tablet, film coated 1,333,092 L.L
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