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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
A10BA02 MET-FORTE G Metformin HCl - 850mg 850mg Tablet 355,798 L.L
A10BA02 MINOR G Metformin HCl - 1g 1g Tablet 266,209 L.L
A12CC MAVIT G Magnesium - 100mg, Pyridoxine HCl - 10mg Tablet 654,003 L.L
L01BB04 MAVENCLAD B Cladribine - 10mg 10mg Tablet 200,244,812 L.L
C09DA07 MICARDIS PLUS B Telmisartan - 80mg, Hydrochlorothiazide - 12.5mg Tablet 1,101,951 L.L
N06BA07 MODAFINIL ARROW G Modafinil - 100mg 100mg Tablet 5,361,932 L.L
J02AC01 MYXEN G Fluconazole - 50mg 50mg Tablet 755,112 L.L
A03FA01 METOCLOPRAMIDE G Metoclopramide HCl - 10mg 10mg Tablet 172,012 L.L
C07DA06 MODUCREN B Amiloride HCl - 2.5mg, Timolol (maleate) - 10mg, Hydrochlorothiazide - 25mg Tablet 915,093 L.L
A03FA03 MOTILIUM B Domperidone - 10mg 10mg Tablet 353,431 L.L
J02AC01 MYXEN G Fluconazole - 150mg 150mg Tablet 255,970 L.L
A03FA03 MOTILAT G Domperidone - 10mg 10mg Tablet 221,734 L.L
L01BB04 MAVENCLAD B Cladribine - 10mg 10mg Tablet L.L
G03AA09 MARVELON B Ethinylestradiol - 0.03mg, Desogestrel - 0.15mg Tablet 319,835 L.L
M03BA03 METOFLEX G Methocarbamol - 750mg 750mg Tablet 2,941,671 L.L
M03BA53 METHOFEN PLATINUM G Ibuprofen - 200mg, Methocarbamol - 500mg Tablet 668,082 L.L
C01DX12 MOLSIDOMINE BIOGARAN G Molsidomine - 4mg 4mg Tablet 344,024 L.L
N02CC04 MAXALT B Rizatriptan (benzoate) - 10mg Tablet 439,436 L.L
R05CB06 MUKORAL G Ambroxol - 30mg 30mg Tablet 201,576 L.L
R05CB06 MUCUM G Ambroxol HCl - 15mg/5ml 15mg/5ml Syrup, sugar free, alcohol free 98,101 L.L
P01AB01 METRONIDAL G Metronidazole benzoate - 125mg/5ml 125mg/5ml Syrup 391,634 L.L
R05X MUCOTAL PROMETHAZINE G Promethazine HCl - 2.5mg/5ml, Carbocysteine - 100mg/5ml Syrup 243,172 L.L
R06AA52 MENTEX G Diphenhydramine HCl - 12.5mg/5ml, Dextrometorphan HBr - 15mg/5ml, Pseudoephedrine HCl - 30mg/5ml Syrup 323,866 L.L
R02A MAXILASE MAUX DE GORGE B Alpha-Amylase - 200U.CEIP/ml 200U.CEIP/ml Syrup 342,680 L.L
B03AD04 MALTOFER B Iron trivalent (hydroxide polymaltose) - 10mg/ml 50mg/5ml Syrup 589,947 L.L
B03AD04 MALTOFER B Iron trivalent (hydroxide polymaltose) - 10mg/ml 50mg/5ml Syrup 589,947 L.L
R05CB03 MUCOTAL PEDIATRIQUE G Carbocysteine - 100mg/5ml 100mg/5ml Syrup 298,205 L.L
R05CB03 MUCOTAL ADULTE G Carbocysteine - 250mg/5ml 250mg/5ml Syrup 308,444 L.L
R05CB06 MUCOSOLVAN B Ambroxol HCl - 30mg/5ml 30mg/5ml Syrup 380,307 L.L
R05CB06 MUKORAL G Ambroxol HCl - 30mg/5ml 30mg/5ml Syrup 341,336 L.L
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