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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
M01AB05 DICLO-DENK 50 G Diclofenac sodium - 50mg 50mg Tablet, enteric coated 893,655 L.L
M01AB05 DICLOGESIC G Diclofenac sodium - 50mg 50mg Tablet, enteric coated 205,608 L.L
V03AC03 DIFIRAX G Deferasirox - 250mg 250mg Tablet, dispersible 23,213,276 L.L
V03AC03 DEFIROX G Deferasirox - 500mg 500mg Tablet, dispersible 38,502,953 L.L
V03AC03 DIFIRAX G Deferasirox - 500mg 500mg Tablet, dispersible 38,637,010 L.L
V03AC03 DEFIROX G Deferasirox - 500mg 500mg Tablet, dispersible L.L
N03AG01 DEPAKINE CHRONO B Valproic acid - 145mg, Sodium Valproate - 333mg 500mg Tablet, coated, scored, prolonged release 362,837 L.L
P01BA02 DOLQUINE G Hydroxychloroquine sulfate - 200mg 200mg Tablet, coated 1,191,988 L.L
M01AB55 DIFEN PLUS G Diclofenac potassium - 50mg, Betamethasone - 0.3mg Tablet, coated 503,941 L.L
C05CA03 DIOSMINE BIOGARAN CONSEIL G Diosmin - 600mg 600mg Tablet, coated 761,959 L.L
A03FA03 DOMPERIDONE BIOGARAN G Domperidone - 10mg 10mg Tablet, coated 116,914 L.L
N06DA02 DONEPEZIL BIOGARAN G Donepezil HCl - 5mg 5mg Tablet, coated 1,325,029 L.L
N06DA02 DONEPEZIL BIOGARAN G Donepezil HCl - 10mg 10mg Tablet, coated 1,325,029 L.L
J01AA02 DOXY 50 G Doxycycline (hyclate) - 50mg 50mg Tablet, coated 311,771 L.L
J01AA02 DOXY 100 G Doxycycline (hyclate) - 100mg 100mg Tablet, coated 788,836 L.L
G03HB01 DIANE '35' B Ethinylestradiol - 0.035mg, Cyproterone acetate - 2mg Tablet 494,534 L.L
J05AR27 DOLUTEGRAVIR/LAMIVUDINE/TENOFOVIR DISOPROXIL FUMARATE G Lamivudine - 300mg, Tenofovir disoproxil fumarate - 300mg, Dolutegravir - 50mg Tablet 54,836,160 L.L
V03AC03 DEFERASIROX ARROW G Deferasirox - 90mg 90mg Tablet 8,846,092 L.L
V03AC03 DEFERASIROX ARROW G Deferasirox - 180mg 180mg Tablet 9,056,837 L.L
V03AC03 DEFERASIROX ARROW G Deferasirox - 360mg 360mg Tablet 13,019,366 L.L
M01AB05 DILO G Diclofenac potassium - 50mg 50mg Tablet 223,974 L.L
M01AB55 DIFEN B12 G Diclofenac potassium - 50mg, Betamethasone - 0.3mg, Cyanocobalamin - 5mg Tablet 503,941 L.L
N06AB05 DEPROX G Paroxetine (HCl) - 20mg 20mg Tablet 972,686 L.L
N06AB05 DEPROX G Paroxetine (HCl) - 40mg 40mg Tablet 2,909,099 L.L
C05CA03 DIOVENOR 600 B Diosmin - 600mg 600mg Tablet 544,256 L.L
N06AB06 DEPRINE G Sertraline HCl - 50mg 50mg Tablet 894,615 L.L
R06AX27 DELINE G Desloratadine - 5mg 5mg Tablet 430,030 L.L
R06AX27 DELINE G Desloratadine - 5mg 5mg Tablet 149,742 L.L
R06AX27 DELINE-MED G Desloratadine - 5mg 5mg Tablet 566,974 L.L
N02BE01 DOLIPRANE B Paracetamol - 500mg 500mg Tablet 120,946 L.L
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