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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
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 2,822,386 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 663,077 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 10g/100ml 10g/100ml Injectable solution 3,023,493 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 15g/100ml 15g/100ml Injectable solution 5,688,441 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 11.2g/100ml 11.2g/100ml Injectable solution 789,487 L.L
C01CA06 PHENYLEPHRINE HYDROCHLORIDE G Phenylephrine HCl - 10mg/ml 1% Injectable solution 10,282,281 L.L
C01CA06 PHENYLEPHRINE RENAUDIN G Phenylephrine - 100mcg/ml 100mcg/ml Injectable solution 5,955,910 L.L
C01CA06 PHENYLEPHRINE AGUETTANT G Phenylephrine - 500mcg/10ml 500mcg/10ml Injectable solution 11,464,796 L.L
C01EA01 PROSTIN VR B Alprostadil - 500mcg/ml 500mcg/ml Injectable concentrated solution 19,894,577 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 5mg 5mg Tablet, film coated 1,890,786 L.L
C01EB17 PROCORALAN B Ivabradin (HCl) - 7.5mg 7.5mg Tablet, film coated 1,890,786 L.L
C02KX01 PMS-BOSENTAN G Bosentan (monohydrate) - 125mg 125mg Tablet 77,539,821 L.L
C02KX01 PMS-BOSENTAN G Bosentan (monohydrate) - 62.5mg 62.5mg Tablet 77,539,821 L.L
C04AD03 PENTOXIFYLLINE SR G Pentoxifylline - 1160 400mg Tablet, sustained release 1,478,227 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine - 40mg, Tribenoside - 400mg Suppository 399,121 L.L
C05AX05 PROCTO GLYVENOL B Lidocaine HCl - 2g/100g, Tribenoside - 5g/100g Cream 405,840 L.L
C07AA05 PROBETOL G Propranolol HCl - 10mg 10mg Tablet 126,705 L.L
C07AA05 PROBETOL G Propranolol HCl - 40mg 40mg Tablet 159,981 L.L
C07AB07 PRESCOR 5 G Bisoprolol - 5mg 5mg Tablet, film coated 345,560 L.L
C07AB07 PRESCOR 10 G Bisoprolol - 10mg 10mg Tablet, film coated 460,746 L.L
C07BB07 PRESCOR 5 PLUS G Bisoprolol - 5mg, Hydrochlorothiazide - 12.5mg Tablet, film coated 678,321 L.L
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 5mg, Amlodipine (besylate) - 5mg Tablet 557,695 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 5mg Tablet 770,022 L.L
C09BB04 PRESORYL PLUS G Perindopril arginine - 10mg, Amlodipine (besylate) - 10mg Tablet 770,022 L.L
C09DB01 POVAM G Amlodipine (besylate) - 5mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
C09DB01 POVAM G Amlodipine (besylate) - 10mg, Valsartan - 160mg Tablet, film coated 857,372 L.L
C10AA03 PRAVASTATINE ARROW G Pravastatin - 40mg 40mg Tablet, breakable 526,786 L.L
C10AA03 PRAVASTATINE ARROW G Pravastatin - 20mg 20mg Tablet, breakable 526,786 L.L
C10AA07 PMS-ROSUVASTATIN G Rosuvastatin (calcium) - 10mg 10mg Tablet 564,414 L.L
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