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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
P01AB01 METROLAG G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 391,634 L.L
R05DA09 DIACOL G Dextromethorphan HBr - 27mg/15ml 27mg/15ml Syrup 517,379 L.L
S03AA30 SULFACHLOR G Sulfacetamide sodium - 110mg/ml, Chloramphenicol - 5mg/ml Drops solution 202,216 L.L
B01AF01 VAROXA G Rivaroxaban - 15mg 15mg Tablet, film coated 1,343,843 L.L
B05BC01 MANNITOL 10% USP INJECTION G Mannitol - 10% 10% Injectable solution 326,367 L.L
C01EX CARDIOVITEX G Coenzyme Q10 - 300mg, Magnesium oxide - 100mg Tablet 2,822,069 L.L
C09BA01 CAPTACE PLUS G Hydrochlorothiazide - 25mg, Captopril - 50mg Tablet, scored 1,028,487 L.L
C10AA05 ATORLIP 10 G Atorvastatin (calcium) - 10mg 10mg Tablet, film coated 1,052,037 L.L
D07AA02 HYDROCORTISONE ACETATE G Hydrocortisone acetate - 1% 1% Cream 215,015 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 500mg 500mg Capsule 7,332,097 L.L
L01EA01 CEMIVIL G Imatinib - 400mg 400mg Tablet, film coated 41,106,321 L.L
L01XX05 UNIDREA G Hydroxycarbamide (or Hydroxyurea) - 500mg 500mg Capsule, hard 2,539,862 L.L
M01AB05 DICLOGESIC G Diclofenac sodium - 50mg 50mg Tablet, enteric coated 205,608 L.L
M05BA08 ZOLEDRONIC ACID ACCORD G Zoledronic acid - 4mg/5ml 4mg/5ml Injectable concentrate for solution 7,028,741 L.L
N03AB02 ? PHENYTOIN SODIUM 5% USP G Phenytoin (sodium) - 250mg/5ml 5ml Injectable solution 276,448 L.L
P01AB01 METROLE G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 391,634 L.L
R05DA20 ALGOMIEL COUGH SYRUP G Dextromethorphan HBr - 5mg, Carbinoxamine maleate - 2mg Syrup 639,925 L.L
S03CA04 MYCICORT G Hydrocortisone acetate - 5mg, Neomycin sulfate - 5mg Drops suspension 166,381 L.L
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