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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
C09BA03 TENSIKEY COMPLEX G Lisinopril - 20mg, Hydrochlorothiazide - 12.5mg Tablet 536,193 L.L
J01DH51 SYNERGIC G Imipenem - 500mg, Cilastatin - 500mg Injectable powder 1,142,266 L.L
N02BE51 PANADOL COLD AND FLU B Paracetamol - 500mg, Pseudoephedrine HCl - 30mg, Chlorpheniramine maleate - 2mg Tablet 278,175 L.L
A06AD65 MOVICOL B Potassium chloride - 0.0466g, Sodium chloride - 0.3507g, Sodium bicarbonate - 0.1785g, Macrogol 3350 - 13.125g Powder for solution 853,340 L.L
A10BD21 ENFORZA B Saxagliptin HCl - 5mg, Dapagliflozin - 10mg Tablet, film coated 6,072,824 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 5mg, Indapamide - 1.25mg Tablet, film coated 452,875 L.L
N02BE51 HUMEX RHUME B Pseudoephedrine HCl (tablet) - 60mg, Paracetamol (tablet) - 500mg, Paracetamol (capsule) - 500mg, Chlorphenamine maleate (capsule) - 4mg Tablet, capsule 467,657 L.L
A06AD65 MOVICOL PEDIATRIC PLAIN B Potassium chloride - 23.3mg, Sodium chloride - 175.4mg, Sodium bicarbonate - 89.3mg, Macrogol 3350 - 6.563g Powder for solution 624,887 L.L
C09BA04 PRETERAX ARGININE B Perindopril arginine - 2.5mg, Indapamide - 0.625mg Tablet, film coated 452,875 L.L
N02BE71 PYRETHAL G Paracetamol - 200mg, Phenobarbital - 20mg Suppository 147,183 L.L
A06AG11 MINILAX G Sodium citrate (dihydrate) - 900mg/10ml, Sodium lauryl sulfate - 150mg/10ml, Glycerol - 1200mg/10ml, Sorbic acid - 10mg/10ml, Sorbitol - 9.96mg/10ml Solution 474,824 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 10mg, Indapamide - 2.5mg Tablet, film coated 765,990 L.L
G03GA30 PERGOVERIS BioHuman Follitropin alfa - 150IU, Lutropin Alfa - 75IU Injectable powder for solution+diluent 6,523,011 L.L
J01DI54 ZERBAXA B Ceftolozane Sulfate - 1g, Tazobactam (sodium) - 0.5g Injectable powder for concentrate for solution 74,780,802 L.L
A02BC DANLOX QUICK G Omeprazole - 20mg, Sodium bicarbonate - 1680mg Powder 1,323,685 L.L
A06AX01 SUPPOSITOIRE GLYCERINE ENFANT G Glycerol Stearate USP - Suppository 179,179 L.L
C01EX CARDIOVITEX G Coenzyme Q10 - 300mg, Magnesium oxide - 100mg Tablet 2,822,069 L.L
C09BA05 TRILTEC PLUS G Ramipril - 10mg, Hydrochlorothiazide - 12.5mg Tablet 2,243,577 L.L
J01EE01 PAEDIATRIC CO-TRIMOXAZOLE MIXTURE G Trimethoprim - 40mg/5ml, Sulfamethoxazole - 200mg/5ml Suspension 190,698 L.L
S01EC54 SIMBRINZA B Brinzolamide - 1%, Brimonidine tartrate - 0.2% Drops suspension 1,706,680 L.L
A06AX01 SUPPOSITOIRE GLYCERINE ENFANT G Glycerol Stearate USP - Suppository 179,179 L.L
C09BA05 TRILTEC PLUS G Ramipril - 5mg, Hydrochlorothiazide - 12.5mg Tablet 2,189,823 L.L
J01EE01 BACTRIM FORTE B Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 344,024 L.L
S01ED51 DORZOLAMIDE/TIMOLOL BGR G Timolol maleate - 5mg/ml, Dorzolamide HCl - 20mg/ml Drops solution 689,391 L.L
A06AX01 SUPPOSITOIRE GLYCERINE ADULTE G Glycerol Stearate USP - Suppository 179,179 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 20mg Tablet, film coated 2,548,821 L.L
J01EE01 CO-TRIMOXAZOLE G Trimethoprim - 160mg, Sulfamethoxazole - 800mg Tablet 7,529,090 L.L
S01ED51 DORZOPTIC PLUS G Timolol - 0.5%, Dorzolamide HCl - 2% Drops solution 548,288 L.L
C09BB02 ZANIPRESS B Lercanidipine HCl - 10mg, Enalapril maleate - 10mg Tablet, film coated 2,280,949 L.L
G03HB01 DIANE '35' B Ethinylestradiol - 0.035mg, Cyproterone acetate - 2mg Tablet 494,534 L.L
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