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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
J01AA07 TETRACYCLINE G Tetracycline HCl - 250mg 250mg Capsule 1,247,086 L.L
J05AF05 VICONDINE G Lamivudine - 150mg 150mg Tablet, film coated 3,573,725 L.L
L01CE01 TOPOTU G Topotecan HCl - 4mg/4ml 4mg/4ml Injectable concentrated solution 7,253,796 L.L
L01XG01 BORCADE G Bortezomib - 3.5mg 3.5mg Injectable lyophilised powder 11,020,381 L.L
L04AX04 LENALIDOMIDE STRAGEN G Lenalidomide - 15mg 15mg Capsule 33,314,752 L.L
M05BA04 APO-ALENDRONATE G Alendronate (monosodium trihydrate) - 70mg 70mg Tablet 981,005 L.L
N02BF02 PMS-PREGABALIN G Pregabalin - 25mg 25mg Capsule 770,022 L.L
N05AX08 RESPAL 4 G Risperidone - 4mg 4mg Caplet, film coated 557,695 L.L
N07BC51 SUBOXONE G Buprenorphine HCl - 8mg, Naloxone HCl - 2mg Tablet, sublingual 7,382,584 L.L
R05CB01 ACC LONG G N-acetylcysteine - 600mg, Vitamin C - 75mg 600mg Tablet, effervescent 286,238 L.L
A04AA02 GRANI-DENK G Granisetron - 3mg/3ml 3mg/3ml Injectable concentrate for solution 1,679,803 L.L
B05BB02 ELECTROLYE 67 G Calcium gluconate - 0.10g/100ml, Potassium chloride - 0.075g/100ml, Sodium chloride - 0.30g/100ml, Dextrose, H2O - 5.0g/100ml Injectable solution 165,727 L.L
C09AA03 TENSIKEY G Lisinopril - 20mg 20mg Tablet 460,938 L.L
C10AA01 SIMVAKEY G Simvastatin - 20mg 20mg Tablet, film coated 249,955 L.L
J01AA07 TETRAN G Tetracycline HCl - 250mg 250mg Capsule 168,940 L.L
J01DH03 ERTANZ G Ertapenem - 1g 1g Injectable powder 2,521,049 L.L
J05AF05 LAMIVUDINE ARROW G Lamivudine - 300mg 300mg Tablet, coated 7,850,907 L.L
L01CE02 IRINOGEN G Irinotecan HCl - 100mg 100mg Injectable solution 5,239,642 L.L
L01XG01 BORTEZOMIB ACCORD G Bortezomib - 3.5mg 3.5mg Injectable powder for solution 13,007,658 L.L
L04AX04 LENOMA G Lenalidomide - 15mg 15mg Capsule, hard 15,241,884 L.L
M05BA04 MARVIL 70 G Alendronate (monosodium trihydrate) - 70mg 70mg Tablet, coated 1,173,175 L.L
N02BF02 PREGAFORTE 25 G Pregabalin - 25mg 25mg Capsule 700,078 L.L
N05AX08 RISPERIDONE BIOGARAN G Risperidone - 4mg 4mg Tablet, coated, scored 1,105,982 L.L
N07BC51 SUBOXONE G Buprenorphine HCl - 16mg, Naloxone HCl - 4mg Tablet, sublingual 14,284,125 L.L
A04AA02 NEOSET G Granisetron (HCl) - 3mg/3ml 3mg/3ml Injectable solution 405,840 L.L
B05BB02 DEXTROSE 5% IN 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, Dextrose, H2O - 5g/100ml Injectable solution 207,404 L.L
C01DX12 MOLSIDOMINE BIOGARAN G Molsidomine - 4mg 4mg Tablet 344,024 L.L
C10AA01 SIMVASTATIN NORMON G Simvastatin - 20mg 20mg Tablet, film coated 264,737 L.L
D06AX01 FUCIKALT G Fusidic acid (sodium salt) - 2% 2% Ointment 209,895 L.L
J01AA08 VULGA XR G Minocycline - 105mg 105mg Tablet, film coated 3,682,128 L.L
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