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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
R07AA INFASURF B Calfactant - 105mg/3ml 35mg/ml Injectable suspension 23,344,161 L.L
R03AK08 INUVER B Formoterol fumarate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose Inhalation solution 3,493,991 L.L
R03AK08 INUVER NEXTHALER B Formoterol fumarate dihydrate - 6mcg/dose, Beclometasone dipropionate - 100mcg/dose Inhalation powder 4,380,927 L.L
S01BA15 ILUVIEN B Fluocinolone acetonide - 0.19mg 0.19mg Implant 629,182,630 L.L
S01BC01 INDOCOLLYRE B Indometacine - 5mg/5ml 0.10% Drops 408,528 L.L
G03AC08 IMPLANON NXT B Etonogestrel - 68mg 68mg Implant 12,299,971 L.L
L04AX01 IMURAN B Azathioprine - 50mg 50mg Tablet 2,030,546 L.L
C08DA01 ISOPTIN B Verapamil (HCl) - 80mg 80mg Tablet, film coated 397,704 L.L
C08DA01 ISOPTIN SR B Verapamil (HCl) - 240mg 240mg Tablet, film coated, prolonged release 1,128,821 L.L
A10BD09 INCRESYNC B Pioglitazone - 15mg, Alogliptin - 25mg Tablet, film coated 3,897,143 L.L
J01DH03 INVANZ B Ertapenem - 1g 1g Injectable concentrated powder for solution 3,785,604 L.L
A10BD09 INCRESYNC B Pioglitazone - 30mg, Alogliptin - 25mg Tablet, film coated 3,897,143 L.L
N02CC01 IMIGRAN B Sumatriptan (succinate) - 100mg 100mg Tablet, film coated 616,824 L.L
N02CC01 IMIGRAN B Sumatriptan (succinate) - 50mg 50mg Tablet, film coated 378,964 L.L
D06BA51 IALUGEN PLUS B Silver sulfadiazine - 10mg/g, Sodium hyaluronate - 2mg/g Cream 1,064,323 L.L
D06BA51 IALUGEN PLUS B Silver sulfadiazine - 10mg/g, Sodium hyaluronate - 0.5mg/g Gauze 1,463,444 L.L
L04AX06 IMNOVID B Pomalidomide - 2mg 2mg Capsule, hard 407,188,707 L.L
L04AX06 IMNOVID B Pomalidomide - 4mg 4mg Capsule, hard 417,741,356 L.L
M01AB01 INDOCID B Indometacin - 100mg 100mg Suppository 424,910 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 2.5g/50ml 2.5g/50ml Injectable solution 17,011,323 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 5g/100ml 5g/100ml Injectable solution 28,622,366 L.L
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 5g/100ml 5% Injectable solution 29,700,912 L.L
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 2.5g/50ml 5% Injectable solution 14,850,456 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 10g/200ml 10g/200ml Injectable solution 55,897,163 L.L
J06BA02 IG VENA BioHuman Human normal immunoglobulin - 1g/20ml 1g/20ml Injectable solution 7,474,948 L.L
J06BB01 IMMUNORHO BioHuman Human anti-D (rh) immunoglobulin - 300mcg 300mcg Injectable dry powder+diluent 5,794,649 L.L
B02BD04 IMMUNINE BioHuman Plasma coagulation factor IX, human - 600IU 600IU Injectable lyophilised powder for solution+diluent 20,506,214 L.L
J06BB04 IMMUNOGLOBULINE HUMAINE DE L'HEPATITE B LFB BioHuman Hepatitis B immunoglobulin (human) - 100UI/ml 100UI/ml Injectable solution 6,853,730 L.L
J06BB04 IMMUNOGLOBULINE HUMAINE DE L'HEPATITE B LFB BioHuman Hepatitis B immunoglobulin (human) - 500UI/5ml 500UI/5ml Injectable solution 26,599,935 L.L
J06BA02 IMMUNOREL BioHuman Human normal immunoglobulin - 5g/100ml 5% Injectable solution L.L
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