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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
D07XC01 DIPROSALIC B Salicylic acid - 30mg/g, Betamethasone (dipropionate) - 0.5mg/g Ointment 352,087 L.L
B02BX01 DICYNONE B Etamsylate - 250mg/2ml 250mg Injectable solution 482,439 L.L
B02BX01 DICYNONE B Etamsylate - 500mg 500mg Capsule 1,311,590 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.10% Cream 521,411 L.L
D10AD03 DIFFERIN B Adapalene - 0.1g/100g 0.10% Gel 503,941 L.L
N02AA59 DOLOSPASMINE COMP B Codeine phosphate - 40 mg, Hexahydro-adipenine HCl - 50 mg, Propyphenazone - 500 mg Suppository 267,489 L.L
N02AB03 DUROGESIC B Fentanyl - 16.8mg 100mcg/h Patch 5,911,563 L.L
N02AB03 DUROGESIC B Fentanyl - 8.4mg 50mcg/h Patch 3,019,614 L.L
C05BX01 DOXIUM B Calcium dobesilate - 500mg 500mg Capsule 2,151,492 L.L
N02AB03 DUROGESIC B Fentanyl - 4.2mg 25mcg/h Patch 1,509,135 L.L
C05BX01 DOXIUM B Calcium dobesilate - 500mg 500mg Capsule 1,323,685 L.L
C05BX51 DOXIPROCT B Calcium dobesilate - 4%, Lidocaine HCl - 2% Ointment 610,104 L.L
C05BX51 DOXIPROCT PLUS B Calcium dobesilate - 4%, Dexamethasone acetate - 0.0025%, Lidocaine HCl - 2% Ointment 489,159 L.L
B05DB DIANEAL PD4 1.36% GLUCOSE B Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 13.6g/l 1.36% Injectable solution 1,163,270 L.L
C05CA03 DIOVENOR 600 B Diosmin - 600mg 600mg Tablet, film coated 1,089,856 L.L
R01AD58 DYMISTA B Fluticasone propionate - 50mcg/actuation, Azelastine HCl - 137mcg/actuation Spray, suspension 2,183,744 L.L
B05DB DIANEAL PD4 CYCLER 1.36% GLUCOSE B Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 13.6g/l Injectable solution 1,150,329 L.L
C05CA03 DIOVENOR 600 B Diosmin - 600mg 600mg Tablet 544,256 L.L
B05DB DIANEAL PD4 2.27% GLUCOSE B Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 22.7g/l Injectable solution 1,163,270 L.L
B05DB DIANEAL PD4 CYCLER 2.27% GLUCOSE B Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 22.7g/l Injectable solution 1,150,329 L.L
B05DB DIANEAL PD4 3.86% GLUCOSE B Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 38.6g/l Injectable solution 1,111,506 L.L
B05DB DIANEAL PD4 CYCLER 3.86% GLUCOSE B Sodium lactate - 4.48g/l, Magnesium chloride - 0.051g/l, Calcium chloride - 0.184g/l, Sodium chloride - 5.38g/l, Anhydrous glucose - 38.6g/l Injectable solution 1,150,329 L.L
C05CA53 DAFLON B Hesperidin - 50mg, Diosmin - 450mg Tablet, film coated 627,574 L.L
C05CA53 DAFLON B Hesperidin - 50mg, Diosmin - 450mg Tablet, film coated 1,191,988 L.L
C05CA53 DAFLON B Hesperidin - 100mg, Diosmin - 900mg Tablet, film coated 1,256,493 L.L
D10AF51 DUAC ONCE DAILY B Clindamycin (phosphate) - 1%, Benzoyl peroxide - 5% Gel 1,658,302 L.L
B03BA51 DEPOVEX B Aluminium monostearate - 20mg/ml, Cyanocobalamine - 1mg/ml Injectable oily suspension 423,310 L.L
J07CA11 DIPHTHERIA, TETANUS,PERTUSSIS, HEPATITIS B AND HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINE B Diphteria Toxoid1 - ?25Lf (?30IU)/0.5ml, Tetanus toxoid1 - ?2.5Lf (?40IU)/0.5ml, Bordetella pertussis (Whole cell) - ?16OU (?4.0IU)/0.5ml, HBs Antigen (r DNA)1 - ?10mcg/0.5ml, H. Influenza type b, purified capsular polysaccharide2 - 10mcg/0.5ml, 1 adsorbed on aluminium phosphate, Al+++ - ?1.25mg , 2 conjugated to tetanos toxoid carrier protein - Injectable suspension 1,515,854 L.L
N02BE01 DOLIPRANE B Paracetamol - 500mg 500mg Tablet 120,946 L.L
N02BE01 DOLIPRANE B Paracetamol - 500mg 500mg Tablet 120,946 L.L
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