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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
A10BD15 ZYGLOMET XR 5/1000 G Dapagliflozin - 5mg, Metformin HCl XR - 1000mg Tablet, film coated 2,578,386 L.L
B01AE07 DAXATRAN G Dabigatran etexilate (mesilate) - 75mg 75mg Capsule, hard 2,576,338 L.L
B05BC01 MANNITOL 20% INJECTION USP G Mannitol - 20% 20% Injectable solution 374,633 L.L
C09AA05 ACURIL G Ramipril - 5mg 5mg Tablet 614,136 L.L
C10AA02 ATERKEY G Lovastatin - 20mg 20mg Tablet 1,053,573 L.L
D06BA51 HYALO4 PLUS G Hyaluronic acid (sodium) - 0.2%, Silver sulfadiazine - 1% Cream 466,313 L.L
J01CA01 AMPICILLIN G Ampicillin (trihydrate) - 125mg/5ml 125mg/5ml Powder for suspension 174,060 L.L
J01DI02 ZINFORO G Ceftaroline fosamil - 600mg 600mg Injectable powder for concentrate for solution 44,995,862 L.L
J05AF10 HEPCAVIR 1 G Entecavir monohydrate - 1mg 1mg Tablet, film coated 18,998,515 L.L
L01DB01 DOXO-CELL G Doxorubicin HCl - 50mg/25ml 50mg/25ml Injectable solution 1,794,030 L.L
L04AX05 PULMOFIB 267 G Pirfenidone - 267mg 267mg Tablet, film coated 20,481,044 L.L
M05BA07 DRONEL 35 G Risedronate sodium - 35mg 35mg Tablet, film coated 511,940 L.L
N02CC03 ZOLMITRIPTAN BIOGARAN G Zolmitriptan - 2.5mg 2.5mg Tablet, orodispersible 1,683,835 L.L
N05AX12 ZALONIL G Aripiprazole - 10mg 10mg Tablet, orodispersible 1,988,887 L.L
N07CA01 VERTINEX G Betahistine dihydrochloride - 24mg 24mg Tablet, scored 921,492 L.L
R05CB06 MUCOVIC FORTE G Ambroxol HCl - 30mg/5ml 30mg/5ml Solution, sugar free 293,086 L.L
S02AA30 OTOCOL G Chloramphenicol - 50mg/ml, Benzocaine - 50mg/ml Drops 163,949 L.L
A04AD12 APREPITANT BIOGARAN 125MG APREPITANT BIOGARAN 80MG G Aprepitant - 125mg, Aprepitant - 80mg 125mg Capsule 3,246,723 L.L
B05BC01 MANNITOL 20% INJECTION USP G Mannitol - 20% 20% Injectable solution 613,662 L.L
C01EB17 BRADIREM G Ivabradine (HCl) - 5mg 5mg Tablet, film coated 1,134,203 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 5mg 5mg Capsule 794,211 L.L
C10AA03 APO-PRAVASTATIN G Pravastatin Sodium - 40mg 40mg Tablet 958,160 L.L
J01CA01 ANTALPEN G Ampicillin (trihydrate) - 125mg/5ml 125mg/5ml Powder for suspension 174,060 L.L
J05AF10 APO-ENTECAVIR G Entecavir - 0.5mg 0.5mg Tablet 28,943,287 L.L
L01DB01 DOXORUBICINA PHARMINICIO G Doxorubicin HCl - 50mg/25ml 50mg/25ml Injectable concentrate for solution 2,015,764 L.L
M05BA07 MADRONATE G Risedronate sodium - 35mg 35mg Tablet, film coated 724,907 L.L
N05AX12 JOSWE ARIPAL 30 G Aripiprazole - 30mg 30mg Tablet 4,687,323 L.L
N07CA02 CINARIN G Cinnarizine - 75mg 75mg Capsule 490,183 L.L
R05CB06 MUCOVIC FORTE G Ambroxol HCl - 30mg/5ml 30mg/5ml Solution, sugar free 440,268 L.L
A10BD15 DIAFLOZIN PLUS G Metformin HCl XR - 1000mg, Dapagliflozin - 10mg Tablet, film coated 2,483,421 L.L
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