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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
S01EA05 BRIMONIDINE BIOGARAN G Brimonidine tartrate - 2mg/ml 0.20% Drops solution 412,560 L.L
N03AX23 BRIVIACT B Brivaracetam - 10mg/ml 10mg/ml Solution 10,314,804 L.L
N03AX23 BRIVIACT B Brivaracetam - 25mg 25mg Tablet, film coated 9,627,931 L.L
N03AX23 BRIVIACT B Brivaracetam - 50mg 50mg Tablet, film coated 9,627,931 L.L
S01LA06 BEOVU BioTech Brolucizumab - 120mg/ml 120mg/ml Injectable solution L.L
S01LA06 BEOVU BioTech Brolucizumab - 120mg/ml 120mg/ml Injectable solution 44,309,066 L.L
N05BA08 BROMAZEPAM BIOGARAN G Bromazepam - 6mg 6mg Tablet, scored 180,075 L.L
R05CB02 BROMHEXINE G Bromhexine - 4mg/5ml 4mg/5ml Elixir 176,619 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDECORT G Budesonide - 1mg 1mg Respule 1,226,928 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 1mg/2ml 1mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 1mg/2ml 1mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDECORT 200 G Budesonide - 200mcg/actuation 200mcg/actuation Metered dose inhaler 808,993 L.L
R03BA02 BUDENA G Budesonide - 200mcg/actuation 200mcg/actuation Inhalation suspension 1,065,667 L.L
A07EA06 BUDENOFALK B Budesonide - 3mg 3mg Capsule 8,554,692 L.L
R03BA02 BUDENA G Budesonide - 50mcg/actuation 50mcg/actuation Inhalation suspension 823,775 L.L
C03CA02 BURINEX B Bumetanide - 1mg 1mg Tablet 335,961 L.L
C03CA02 BURINEX B Bumetanide - 5mg 5mg Tablet 1,054,916 L.L
N01BB01 BUPIVACAINE AGUETTANT 5MG/ML G Bupivacaine HCl - 100mg/20ml 100mg/20ml Injectable solution 3,078,743 L.L
N01BB01 BUPIVACAINE AGUETTANT for spinal anaesthesia G Bupivacaine HCl - 20mg/4ml 20mg/4ml Injectable solution 1,554,826 L.L
N01BB01 BUPIVACAINE HEAVY PANPHARMA G Bupivacaine HCl - 20mg/4ml 20mg/4ml Injectable solution 2,586,897 L.L
N01BB01 BUPIVACAINE AGUETTANT 2.5MG/ML G Bupivacaine HCl - 50mg/20ml 50mg/20ml Injectable solution 2,736,063 L.L
N07BC01 BUVIDAL B Buprenorphine - 128mg 128mg Injectable solution prolonged release 34,835,645 L.L
N07BC01 BUVIDAL B Buprenorphine - 16mg 16mg Injectable solution prolonged release 8,524,771 L.L
N07BC01 BUVIDAL B Buprenorphine - 24mg 24mg Injectable solution prolonged release 8,524,771 L.L
N07BC01 BUPRENORPHINE ARROW G Buprenorphine - 2mg 2mg Tablet 563,070 L.L
N07BC01 BUVIDAL B Buprenorphine - 32mg 32mg Injectable solution prolonged release 8,524,771 L.L
N07BC01 BUVIDAL B Buprenorphine - 64mg 64mg Injectable solution prolonged release 34,835,645 L.L
N07BC01 BUPENSAN G Buprenorphine - 8mg 8mg Tablet 1,259,180 L.L
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