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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
C05A ANTROLIN B Nifedipine - 0.3%, Lidocaine - 1.5% Cream 1,333,092 L.L
N02AJ06 ALGOCOD G Paracetamol - 500mg, Codeine phosphate - 30mg Tablet, effervescent 299,677 L.L
R01BA53 AURIMEL B Phenylephrine HCl - 5mg/5ml, Sodium citrate - 325mg/5ml, Carbinoxamine maleate - 2mg/5ml, Dextromethorphan HBr - 5mg/5ml Syrup 319,963 L.L
N02AJ08 ASTEFOR G Ibuprofen - 400mg, Codeine phosphate hemihydrate - 30mg Tablet, film coated 935,314 L.L
N02AJ13 ALGODOL G Paracetamol - 325mg, Tramadol HCl - 37.5mg Capsule 317,403 L.L
R02A ANGINOVAG G Lidocaine HCl - 100mg/100ml, Hydrocortisone acetate - 60mg/100ml, Tyrothricin - 400mg/100ml, Dequalinium chloride - 100mg/100ml, β-Glycerrhetinic acid - 60mg/100ml Spray 651,764 L.L
J07BX05 ABRYSVO B RSV subgroup A stabilized perfusion F antigen 60mcg - 60mcg, RSV subgroup B stabilized perfusion F antigen 60mcg - 60mcg, Glycoprotein F stabilized in the perfusion conformation - Injectable powder + solvent 22,650,721 L.L
N02BA51 ASPIRINE C EFFERVESCENT B Acetylsalicylic acid - 400mg, Vitamin C - 240mg Tablet, effervescent 162,605 L.L
N02BA51 ASPRIVIT G Acetylsalicylic acid - 500mg, Caffeine - 50mg, Vitamin B1 - 2mg Tablet 186,794 L.L
M01AE51 ADVIL COLD & SINUS B Ibuprofen - 200mg, Pseudoephedrine HCl - 30mg Caplet, coated 288,926 L.L
C09DA03 ARBITEN PLUS G Valsartan - 160mg, Hydrochlorothiazide - 12.5mg Tablet 544,256 L.L
C09DA03 ARBITEN PLUS G Valsartan - 160mg, Hydrochlorothiazide - 25mg Tablet 579,196 L.L
L04AA32 APRIVA STARTER PACK G Apremilast - 10mg, Apremilast - 20mg, Apremilast - 30mg Tablet, film coated 22,154,866 L.L
C09DA04 ANDARAN PLUS G Irbesartan - 150mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 598,051 L.L
C10BA05 ATOZET B Atorvastatin - 10mg, Ezetimibe - 10mg Tablet, film coated 1,624,706 L.L
R03AK13 AEROCORT-A HFA G Salbutamol - 100mcg/dose, Beclometasone - 50mcg/dose Metered dose inhaler 541,569 L.L
C10BA05 ATOZET B Atorvastatin - 10mg, Ezetimibe - 10mg Tablet, film coated 1,624,706 L.L
R03AL01 ATROVENT COMP. HFA B Fenoterol Hydrobromide - 20mcg/actuation, Ipratropium bromide - 50mcg/actuation Inhalation aerosol metered dose 544,256 L.L
C10BA05 ATOZET B Atorvastatin - 20mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
C09DA04 ANDARAN PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 598,051 L.L
C10BA05 ATOZET B Atorvastatin - 20mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
R03AL03 ANORO ELLIPTA B Vilanterol - 25mcg, Umeclidinium bromide - 62.5mcg Inhalation powder 5,367,774 L.L
B05AA01 ALBUTEIN BioHuman Albumin human - 20% Injectable solution 4,031,528 L.L
C10BA05 ATOZET B Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
C10BA05 ATOZET B Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 2,046,672 L.L
C09DA04 ANDARAN PLUS G Irbesartan - 300mg, Hydrochlorothiazide - 25mg Tablet, film coated 940,435 L.L
C09DA06 ATACAND PLUS B Candesartan cilexetil - 16mg, Hydrochlorothiazide - 12.5mg Tablet 705,517 L.L
B05BA01 AMINOVEN 10% B Glacial Acetic Acid 99% - 5.297g/l, L-Proline - 15.0g/l, L-Alanine - 15.0g/l, Glycine - 14.0g/l, L-Histidine - 3.00g/l, L-Arginine - 12.0g/l, L-Valine - 6.20g/l, L-Tryptophan - 2.00g/l, L-Threonine - 4.40g/l, L-Phenylalanine - 5.10g/l, L-Methionine - 4.30g/l, L-Lysine (monoacetate) - 6.60g/l, L-Leucine - 7.40g/l, L-Isoleucine - 5.00g/l Injectable solution 951,440 L.L
A03BB01 ANTIPAN G Hyoscine N butylbromide - 20mg/ml Injectable solution 355,798 L.L
A03BB01 ANTIPAN G Hyoscine N butylbromide - 20mg/ml Injectable solution 2,557,140 L.L
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