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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
R06AD52 FLUISEDAL G Promethazine HCl - 2.5g/5ml, Meglumine benzoate - 130mg/5ml, Polysorbate 20 - 15mg/5ml Syrup 572,634 L.L
L02BG04 FEMAZOL G Letrozole - 2.5mg 2.5mg Tablet, film coated 1,433,432 L.L
R06AD52 FLUISEDAL G Promethazine HCl - 2.5g/5ml, Meglumine benzoate - 130mg/5ml, Polysorbate 20 - 15mg/5ml Syrup 393,746 L.L
R06AE07 FINALLERG G Cetirizine (dihydrochloride) - 10mg 10mg Tablet, film coated 342,680 L.L
R06AE07 FINALLERG G Cetirizine (dihydrochloride) - 5mg/5ml 5mg/5ml Solution 170,668 L.L
N06AB03 FLUOXETINE BIOGARAN G Fluoxetine (HCl) - 20mg 20mg Capsule 239,204 L.L
N06AB03 FLUTIN G Fluoxetine (HCl) - 20mg 20mg Capsule 362,837 L.L
M01AE01 FEBRIDEX ELIXIR G Ibuprofen - 100mg/5ml 100mg/5ml Elixir 262,369 L.L
B03AA02 FERRATE G Ferrous fumarate - 20mg/ml (iron element) 20mg/ml Suspension 667,890 L.L
M01AE01 FEVERAL G Ibuprofen - 100mg/5ml 100mg/5ml Suspension 309,724 L.L
B03AA02 FEOSTA G Ferrous fumarate - 200mg 200mg Tablet, film coated 682,160 L.L
B03AA02 FEOSTA G Ferrous fumarate - 200mg 200mg Tablet, film coated 9,355,300 L.L
J01CR50 FLUMOX G Flucloxacillin (monohydrate) - 250mg, Amoxicillin (trihydrate) - 250mg Capsule 348,055 L.L
R06AX FRENALER CORT G Desloratadine - 1mg/ml, Betamethasone - 0.05mg/ml Syrup 741,801 L.L
R06AX FRENALER CORT G Desloratadine - 5mg, Betamethasone - 0.6mg Tablet, film coated 632,950 L.L
B03AC FER PANPHARMA G Iron (sucrose) - 100mg/5ml 100mg/5ml Injectable solution 2,315,441 L.L
B03AC FER PANPHARMA G Iron (sucrose) - 100mg/5ml 100mg/5ml Injectable solution 2,315,441 L.L
B03AC FEROMAX G Iron trivalent (hydroxide sucrose complex) - 100mg/5ml 100mg/5ml Injectable solution 2,213,309 L.L
B03AC FERRASIL G Iron (sucrose) - 100mg/5ml 100mg/5ml Injectable solution 2,194,047 L.L
B03AC FERAPPLIC G Iron trivalent (ferric carboxymaltose) - 500mg/10ml 500mg/10ml Injectable dispersion 34,231,559 L.L
J01MA12 FLOBIOX G Levofloxacin - 500mg 500mg Tablet, film coated 629,686 L.L
J01MA12 FLOBIOX G Levofloxacin - 500mg 500mg Tablet, film coated 794,787 L.L
J01MA12 FLOXIN-L 500 G Levofloxacin (hemihydrate) - 500mg 500mg Tablet, film coated 831,903 L.L
B03AD03 FOLIFER G Folic acid - 1mg, Iron bivalent (as dried ferrous sulfate) - 90mg Tablet, film coated 1,408,347 L.L
R06AX26 FENADEX 120 G Fexofenadine HCl - 120mg 120mg Tablet, film coated 295,645 L.L
R06AX26 FENADEX 180 G Fexofenadine HCl - 180mg 180mg Tablet, film coated 295,645 L.L
J01MA12 FLOBIOX G Levofloxacin - 750mg 750mg Tablet, film coated 945,809 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 100mcg Capsule, inhalation 1,777,706 L.L
B03BB01 FOLICIL G Folic acid - 5mg 5mg Tablet 584,571 L.L
R03AK06 FLUDALT DUO G Salmeterol (xinafoate) - 50mcg, Fluticasone propionate - 250mcg Capsule, inhalation 2,487,891 L.L
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