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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
L04AA32 OTEZLA B Apremilast - 30mg 30mg Tablet, film coated 49,829,454 L.L
L04AA37 OLUMIANT B Baricitinib - 2mg 2mg Tablet, film coated 68,053,864 L.L
L04AA37 OLUMIANT B Baricitinib - 4mg 4mg Tablet, film coated 68,053,864 L.L
C10BA05 OTOREZA G Atorvastatin - 10mg, Ezetimibe - 10mg Tablet, film coated 908,438 L.L
C10BA05 OTOREZA 10/10 G Atorvastatin - 10mg, Ezetimibe - 10mg Tablet, film coated 454,219 L.L
C10BA05 OTOREZA 10MG/20MG G Atorvastatin - 20mg, Ezetimibe - 10mg Tablet, film coated 858,715 L.L
C10BA05 OTOREZA 10MG/40MG G Atorvastatin - 40mg, Ezetimibe - 10mg Tablet, film coated 1,144,954 L.L
C02KX04 OPSUMIT B Macitentan - 10mg 10mg Tablet, film coated L.L
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 40mg, Hydrochlorothiazide - 25mg Tablet, film coated 653,107 L.L
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 40mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 653,107 L.L
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 25mg Tablet, film coated 628,918 L.L
C09DA08 OLMENOR PLUS G Olmesartan medoxomil - 20mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 628,918 L.L
C09DB02 OLMENOR COMBI G Olmesartan medoxomil - 20mg, Amlodipine - 5mg Tablet, film coated 679,984 L.L
C09DB02 OLMENOR COMBI G Olmesartan medoxomil - 40mg, Amlodipine - 5mg Tablet, film coated 772,709 L.L
A04AA01 ONDAKEY G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, film coated 4,489,778 L.L
A04AA01 ONDANSETRON MEDIS G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, film coated 748,520 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 10mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,067,011 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 10mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,067,011 L.L
M04AA03 OXUBAT 120 G Febuxostat - 120mg 120mg Tablet, film coated 1,549,002 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 20mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,037,446 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 25mg Tablet, film coated 1,067,011 L.L
C09DX03 OLMENOR TRIPLE G Olmesartan medoxomil - 40mg, Amlodipine (besylate) - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 1,067,011 L.L
M04AA03 OXUBAT 80 G Febuxostat - 80mg 80mg Tablet, film coated 1,549,002 L.L
M05BA07 OSTERAL G Risedronate sodium - 35mg 35mg Tablet, film coated 511,940 L.L
A05AA04 OCALIVA B Obeticholic acid - 10mg 10mg Tablet, film coated 224,503,943 L.L
A05AA04 OCALIVA B Obeticholic acid - 5mg 5mg Tablet, film coated 224,503,943 L.L
R01BA52 ORADUS P G Pseudoephedrine sulfate - 120mg, Desloratadine - 2.5mg Tablet, extended release 746,153 L.L
R01BA52 ORADUS P G Pseudoephedrine sulfate - 120mg, Desloratadine - 2.5mg Tablet, extended release 255,970 L.L
A02BC01 OMEDAR G Omeprazole - 20mg 20mg Tablet, enteric coated 18,087,352 L.L
N06AB03 OXETINE 20 G Fluoxetine (HCl) - 20mg 20mg Tablet, coated 362,837 L.L
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