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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
C09DB07 CANDAM G Candesartan cilexetil - 16mg, Amlodipine - 5mg Capsule, hard 1,376,095 L.L
L01BC59 LONSURF B Trifluridine - 15mg, Tipiracil - 6.14mg Tablet, film coated 58,102,683 L.L
M03BB53 RELAXON G Paracetamol - 300mg, Chlorzoxazone - 250mg Capsule 296,989 L.L
N02BE51 HUMACE PLUS G Paracetamol - 500mg, Aceclofenac (potassium) - 200mg Tablet 575,165 L.L
S01ED51 TRAVOPROST/TIMOLOL BIOGARAN G Travoprost - 40mcg/ml, Timolol - 5mg/ml Drops solution 849,308 L.L
B05BB02 MIXTE SIMPLE (2) G Sodium chloride - 0.9g/100ml, Dextrose, H2O - 5g/100ml Injectable solution 207,894 L.L
C09DB07 CORONOPINE G Candesartan cilexetil - 16mg, Amlodipine - 5mg Capsule, hard 1,638,144 L.L
M03BC51 NORGESIC B Paracetamol - 450mg, Orphenadrine (citrate) - 35mg Tablet 412,560 L.L
N02BE51 PANADOL MIGRAINE B Paracetamol - 250mg, Acetylsalicylic acid - 250mg, Caffeine - 65mg Caplet 604,729 L.L
S01ED51 LOPROSTAN G Timolol - 5mg/ml, Latanoprost - 50?g/ml Drops 768,678 L.L
B05BB02 SERUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 194,211 L.L
C09DB07 CANDAM G Candesartan cilexetil - 16mg, Amlodipine - 10mg Capsule, hard 1,376,095 L.L
D04AA32 DERMAMINE ITCH STOPPING G Diphenhydramine HCl - 1%, Zinc acetete - 0.1% Cream 560,382 L.L
M03BC51 MUSCEROL 2 G Paracetamol - 450mg, Orphenadrine (citrate) - 35mg Tablet, scored 177,899 L.L
N02BE51 EXTRA STRENGTH HEADACHE RELIEF G Acetaminophen - 250mg, Acetylsalicylic acid - 250mg, Caffeine - 65mg Tablet 353,431 L.L
S01ED51 COMBISOPT G Timolol maleate - 5mg/ml, Dorzolamide HCl - 20mg/ml Drops solution 935,570 L.L
A10BD02 GLUCOVANCE B Metformin HCl - 500mg, Glibenclamide - 2.5mg Tablet, film coated 563,663 L.L
B05BB02 SERUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 180,421 L.L
C09DB07 CORONOPINE G Candesartan cilexetil - 16mg, Amlodipine - 10mg Capsule, hard 1,540,044 L.L
M03BC51 MUSCEROL EXTRA G Caffeine - 15mg, Paracetamol - 450mg, Orphenadrine citrate - 35mg Tablet, scored 267,489 L.L
A10BD02 GLYSTOR PLUS G Metformin HCl - 500mg, Glibenclamide - 2.5mg Tablet, film-scored 533,697 L.L
B05BB02 SOLUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 222,941 L.L
C09DB07 CORONOPINE G Candesartan cilexetil - 8mg, Amlodipine - 10mg Capsule, hard 1,368,032 L.L
M03BC51 MUSCEROL 3 G Paracetamol - 450mg, Orphenadrine citrate - 35mg, Ibuprofen - 200mg Tablet, film coated 593,850 L.L
A10BD02 GLUCOVANCE B Metformin HCl - 500mg, Glibenclamide - 5mg Tablet, film coated 775,971 L.L
B05BB02 SOLUFLEX DEXTROSE 5% SODIUM CHLORIDE 0.9% INJECTION, USP G Sodium chloride - 0.9%, Glucose - 5% Injectable solution 158,587 L.L
C09DX LOSANET AM PLUS G Losartan potassium - 100mg, Amlodipine - 10mg, Hydrochlorothiazide - 12.5mg Tablet 1,044,358 L.L
M03BX DORIXINA RELAX B Lysine clonixinate - 125mg, Cyclobenzaprine HCl - 5mg Tablet, film coated 581,884 L.L
N02BE51 REMIDOL G Paracetamol - 650mg, Dextromethorphan HBr - 20mg, Chlorphenamine maleate - 4mg Granules for solution 537,537 L.L
A10BD02 GLYSTOR PLUS G Metformin HCl - 500mg, Glibenclamide - 5mg Tablet, film-scored 691,119 L.L
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