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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
C01EB17 BRAVIGO G Ivabradine (HCl) - 7.5mg 7.5mg Tablet, film coated 1,237,679 L.L
C09AA05 ACURIL G Ramipril - 10mg 10mg Tablet 810,337 L.L
C10AA03 STAVACOR G Pravastatin sodium - 20mg 20mg Tablet, scored 725,419 L.L
D06BB10 GENIMOD G Imiquimod - 5% 5% Cream 2,268,406 L.L
J01CA01 AMPICILLINE PANPHARMA G Ampicillin (sodium) - 500mg 500mg Injectable powder for solution 1,944,540 L.L
J05AF10 HEPCAVIR 0.5 G Entecavir monohydrate - 0.5mg 0.5mg Tablet, film coated 18,998,515 L.L
L01DB03 EPIRUBICINE VIATRIS 2MG/ML G Epirubicin HCl - 50mg/25ml 50mg/25ml Injectable solution 3,914,242 L.L
M01AB01 INDOMEL G Indometacin - 25mg 25mg Capsule 170,220 L.L
M05BA07 PMS-RISEDRONATE G Risedronate sodium - 150mg 150mg Tablet 806,306 L.L
N02CX01 APIZINE G Pizotifen - 0.25mg/5ml 0.25mg/5ml Syrup 505,541 L.L
N05AX12 XALIPRO G Aripiprazole - 15mg 15mg Tablet 2,418,917 L.L
R05CB10 DILAMUC G Dried Ivy leaf extract - 170mg/100ml, Glycyrrhizic acid (Glycyrrhiza Glabra, Liquorice root) - 164mg/100ml, Thyme - 760mg/100ml Syrup 456,906 L.L
B01AF01 RIBAVAN G Rivaroxaban - 2.5mg 2.5mg Tablet, film coated 3,199,625 L.L
B05BC01 SOLUFLEX MANNITOL 20% INJECTION, USP G Mannitol - 20g/100ml 20g/100ml Injectable solution 603,320 L.L
C01EB17 IVABRADINE ARROW G Ivabradine (HCl) - 7.5mg 7.5mg Tablet, film coated, scored 1,323,685 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 10mg 10mg Capsule 1,178,550 L.L
C10AA03 STAVACOR G Pravastatin sodium - 10mg 10mg Tablet, scored 1,695,801 L.L
D06BB10 JEDARA G Imiquimod - 5% 5% Cream 3,850,109 L.L
J01CA01 AMPICILLINE PANPHARMA G Ampicillin (sodium) - 1g 1g Injectable powder for solution 2,857,009 L.L
N05AX12 ZALONIL G Aripiprazole - 15mg 15mg Tablet, orodispersible 2,426,980 L.L
A06AB02 SUPPOLAX G Bisacodyl - 10mg 10mg Suppository 598,051 L.L
B05BC01 MANNITOL G Mannitol - 10g/100ml 10g/100ml Injectable solution 329,815 L.L
C09AA05 NORMOPRIL G Ramipril - 10mg 10mg Tablet 599,354 L.L
C10AA05 APO-ATORVASTATIN G Atorvastatin (calcium) - 10mg 10mg Tablet 889,624 L.L
D06BB53 ACTI-VIR H G Aciclovir - 5%, Hydrocortisone acetate - 1% Cream 833,182 L.L
J01CA04 AMOXICILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 6,199,145 L.L
J01FA09 CLAMYCIN G Clarithromycin - 250mg 250mg Tablet, film coated 641,205 L.L
J05AG01 NEPINE G Nevirapine - 200mg 200mg Tablet 5,921,678 L.L
L01DB07 MITOXANTRON EBEWE G Mitoxantrone - 20mg/10ml 20mg/10ml Injectable concentrated solution 11,064,120 L.L
M01AB01 INDOMEL G Indometacin - 100mg 100mg Suppository 222,694 L.L
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