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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
C09AA05 TRILTEC G Ramipril - 1.25mg 1.25mg Capsule 524,739 L.L
L04AD02 PROGRAF 1MG B Tacrolimus - 1mg 1mg Capsule L.L
L04AX02 THALIDOMIDE BMS B Thalidomide - 50mg 50mg Capsule 27,387,764 L.L
L04AD02 PROGRAF 5MG B Tacrolimus - 5mg 5mg Capsule L.L
L04AX02 THALIDOMIDE CELGENE B Thalidomide - 50mg 50mg Capsule 27,387,764 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 2.5mg 2.5mg Capsule 463,626 L.L
M03BB53 PARAXONE-JPI G Paracetamol - 300mg, Chlorzoxazone - 250mg Capsule 334,617 L.L
A02BC01 AXIPRON G Omeprazole - 20mg 20mg Capsule 373,358 L.L
J01CA01 ANTALPEN G Ampicillin (trihydrate) - 250mg 250mg Capsule 218,854 L.L
M03BB53 RELAXON G Paracetamol - 300mg, Chlorzoxazone - 250mg Capsule 296,989 L.L
A02BC01 DIGCAP G Omeprazole - 20mg 20mg Capsule 593,850 L.L
C09AA05 TRILTEC G Ramipril - 2.5mg 2.5mg Capsule 255,970 L.L
J01CA01 ANTALPEN G Ampicillin (trihydrate) - 500mg 500mg Capsule 285,407 L.L
L04AX04 REVLIMID B Lenalidomide - 10mg 10mg Capsule L.L
A02BC01 EPIRAZOLE G Omeprazole - 20mg 20mg Capsule 208,296 L.L
A02BC01 GASTRAZOLE G Omeprazole - 20mg 20mg Capsule 185,450 L.L
A02BC01 GASTRAZOLE G Omeprazole - 20mg 20mg Capsule 377,620 L.L
C09AA05 APO-RAMIPRIL G Ramipril - 5mg 5mg Capsule 794,211 L.L
J01CA04 AMOXICILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 6,199,145 L.L
J01CA04 AMOXICILLINE ARROW LAB G Amoxicillin (trihydrate) - 500mg 500mg Capsule 564,414 L.L
L04AX04 REVLIMID B Lenalidomide - 5mg 5mg Capsule 105,106,076 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 500mg 500mg Capsule 254,690 L.L
L04AX04 APO-LENALIDOMIDE G Lenalidomide - 5mg 5mg Capsule 49,795,454 L.L
A02BC01 GASTRISEC G Omeprazole - 20mg 20mg Capsule 413,903 L.L
C09AA05 TRILTEC G Ramipril - 5mg 5mg Capsule 447,948 L.L
J01CA04 AMOXIDREX G Amoxicillin (trihydrate) - 500mg 500mg Capsule 7,332,097 L.L
N02BE51 PARACETAMOL/CAFEINE/CODEINE BIOGARAN G Paracetamol - 400mg, Caffeine - 50mg, Codeine - 20mg Capsule 548,288 L.L
A02BC01 HYPOSEC G Omeprazole - 20mg 20mg Capsule 659,827 L.L
A07AA02 MEDISTAN G Nystatin - 500,000IU 500,000IU Capsule 417,231 L.L
J01CA04 AMOXYCILLIN G Amoxicillin (trihydrate) - 500mg 500mg Capsule 4,073,187 L.L
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