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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
A03AX12 SPASFON B Phloroglucinol hydrate - 80mg, Trimethylphloroglucinol - 80mg Tablet, coated 278,175 L.L
A03AX SPASMO-DIGESTIN B Simethicone - 30mg, Dicyclomine HCl - 5mg, Sodium dihydrocholate - 10mg, Sanzyme 3500 - 36mg, Papain - 100mg Tablet, enteric coated 260,705 L.L
A03AX HEPABYL G Sorbitol - 2.5g/5ml, Diisopromine - 0.02g/5ml Liquid 238,052 L.L
A03AX COLPERMIN B Pepermint oil - 187mg 187mg Capsule, delayed release 632,950 L.L
A03AB06 NOSPAZM G Otilonium bromide - 40mg 40mg Tablet, film coated 282,207 L.L
A03AB06 SPASMOMEN B Otilonium bromide - 40mg 40mg Tablet, film coated 438,093 L.L
A03AB02 GLYCOPYRROLATE B Glycopyronium Bromide - 0.2mg/ml 0.2mg/ml Injectable solution 7,238,185 L.L
A03AA04 BEVACOL 135 G Mebeverine HCl - 135mg 135mg Tablet, film coated 532,162 L.L
A03AA04 SPASMINE (Mebeverine HCl 200mg SR) G Mebeverine HCl - 200mg 200mg Capsule, slow release 712,876 L.L
A03AA04 DUSPATALIN RETARD B Mebeverine HCl - 200mg 200mg Capsule 895,581 L.L
A03A SPASMOBROM B Pipethanate Ethobromide - 20mg 20mg Tablet, coated 705,517 L.L
A02BX13 GAVISCON PEPPERMINT LIQUID B Sodium alginate - 250mg/10ml, Sodium bicarbonate - 133.5mg/10ml, Calcium (carbonate) - 80mg/10ml Suspension 393,746 L.L
A02BX13 GAVISCON DOUBLE ACTION B Sodium alginate - 500mg, Sodium bicarbonate - 213mg, Calcium (carbonate) - 325mg Suspension 517,379 L.L
A02BX13 GAVISCON DOUBLE ACTION MINT B Sodium alginate - 500mg/10ml, Sodium bicarbonate - 213mg/10ml, Calcium (carbonate) - 325mg/10ml Suspension 542,912 L.L
A02BX13 GAVISCON DOUBLE ACTION MINT B Sodium alginate - 250mg, Sodium bicarbonate - 106.5mg, Calcium (carbonate) - 187.5mg Tablet, chewable 456,906 L.L
A02BX13 GAVISCON ADVANCE ANISEED FLAVOR B Sodium alginate - 1000mg/10ml, Potassium hydrogen carbonate - 200mg/10ml Suspension 514,692 L.L
A02BX13 GAVISCON INFANT B Sodium alginate - 225mg, Magnesium alginate - 87.5mg Powder for suspension 710,893 L.L
A02BX13 GAVISCON B Sodium alginate - 500mg/10ml, Sodium bicarbonate - 267mg/10ml, Calcium (carbonate) - 160mg/10ml Liquid 295,645 L.L
A02BX02 SUCRATE GEL G Sucralfate - 1g 1g Gel 636,981 L.L
A02BD08 PYLERA B Bismuth subcitrate potassium - 140mg, Tetracycline HCl - 125mg, Metronidazole - 125mg Capsule 6,156,142 L.L
A02BC07 DEXPURE B Dexrabeprazole sodium - 10mg 10mg Tablet, enteric coated 517,379 L.L
A02BC06 DEXILANT B Dexlansoprazole - 60mg 60mg Capsule, delayed release 2,375,914 L.L
A02BC06 DEXILANT B Dexlansoprazole - 30mg 30mg Capsule, delayed release 1,595,141 L.L
A02BC05 NEXIUM B Esomeprazole (magnesium trihydrate) - 10mg 10mg Granules, gastroresistant, for suspension 1,721,462 L.L
A02BC05 NEXIUM B Esomeprazole (magnesium trihydrate) - 10mg 10mg Granules, gastroresistant, for suspension 1,721,462 L.L
A02BC05 SOLEZOL G Esomeprazole - 40mg 40mg Injectable powder for solution 301,021 L.L
A02BC05 ESSIUM G Esomeprazole - 40mg 40mg Injectable powder for solution 314,459 L.L
A02BC05 ESOMEPRAZOLE NORMON G Esomeprazole - 40mg 40mg Injectable powder for solution 430,030 L.L
A02BC05 ESAC G Esomeprazole sodium - 40mg 40mg Injectable powder for solution 430,030 L.L
A02BC05 NEXIUM B Esomeprazole sodium - 40mg 40mg Injectable powder for solution 5,254,424 L.L
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