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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
L01FG01 ZIRABEV BioTech Bevacizumab - 100mg/4ml 100mg/4ml Injectable solution 14,800,115 L.L
J01XX08 ZERSA G Linezolide - 100mg/5ml 100mg/5ml Suspension 20,406,792 L.L
J01DD13 ZAKON G Cefpodoxime (proxetil) - 100mg/5ml 100mg/5ml Powder for suspension 1,116,733 L.L
B01AF01 ZARLAN G Rivaroxaban - 10mg 10mg Tablet, film coated 1,439,255 L.L
A10BK01 ZYGLOR 10 G Dapagliflozin - 10mg 10mg Tablet, film coated 2,039,953 L.L
R06AE07 ZYRTEC B Cetirizine (dihydrochloride) - 10mg 10mg Tablet, film coated 593,978 L.L
N06AB10 ZELAX 10 G Escitalopram (oxalate) - 10mg 10mg Caplet 833,182 L.L
C10AX09 ZEMIL G Ezetimibe - 10mg 10mg Tablet 944,529 L.L
N05AH03 ZYPREXA VELOTAB B Olanzapine - 10mg 10mg Tablet, dispersible 5,214,109 L.L
N05AH03 ZYPREXA VELOTAB B Olanzapine - 10mg 10mg Tablet, dispersible 5,214,109 L.L
N05AH03 ZOLAPINE G Olanzapine - 10mg 10mg Tablet, orodispersible 2,106,249 L.L
N05AH03 ZYRWAN OD G Olanzapine - 10mg 10mg Tablet, orodispersible 2,564,819 L.L
N05AH03 ZYPREXA B Olanzapine - 10mg 10mg Tablet 1,468,820 L.L
N05AH03 ZYPREXA B Olanzapine - 10mg 10mg Tablet 1,468,820 L.L
C10AA01 ZOCOR B Simvastatin - 10mg 10mg Tablet 881,817 L.L
C09AA03 ZESTRIL B Lisinopril (dihydrate) - 10mg 10mg Tablet 592,635 L.L
N05AX12 ZALONIL G Aripiprazole - 10mg 10mg Tablet, orodispersible 1,988,887 L.L
N07CA03 ZINASEN G Flunarizine (HCl) - 10mg 10mg Tablet 599,354 L.L
L01DB06 ZAVEDOS B Idarubicin HCl - 10mg 10mg Injectable freeze dried material 12,071,013 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 120mg 120mg Capsule, controlled release 517,059 L.L
C09CA04 ZIOREL G Irbesartan - 150mg 150mg Tablet, film coated 575,933 L.L
B01AF01 ZARLAN G Rivaroxaban - 15mg 15mg Tablet, film coated 2,015,764 L.L
B01AF01 ZARLAN G Rivaroxaban - 15mg 15mg Tablet, film coated 1,343,843 L.L
N05AX12 ZALONIL G Aripiprazole - 15mg 15mg Tablet, orodispersible 2,426,980 L.L
C08DB01 ZALDEM CR G Diltiazem HCl - 180mg 180mg Capsule, controlled release 966,287 L.L
J01XA01 ZERMACIN G Vancomycin (HCl) - 1g 1g Injectable lyophilised powder for solution 1,066,115 L.L
J01XA01 ZERMACIN G Vancomycin (HCl) - 1g 1g Injectable lyophilised powder for solution 6,911,190 L.L
L02BG03 ZORTEX G Anastrozole - 1mg 1mg Tablet, film coated 1,944,092 L.L
N02CC03 ZOLMITRIPTAN ARROW GENERIGUES G Zolmitriptan - 2.5mg 2.5mg Tablet, film coated 1,726,838 L.L
N02CC03 ZOLMITRIPTAN ARROW GENERIGUES G Zolmitriptan - 2.5mg 2.5mg Tablet, film coated 857,372 L.L
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