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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
R05CB06 FLUIBRON G Ambroxol - 15mg/5ml 15mg/5ml Syrup 459,594 L.L
M05BB03 FOSAVANCE B Alendronic acid (sodium alendronate) - 70mg, Colecalciferol - 5600IU Tablet 1,988,887 L.L
C03CA01 FURESIX 40 G Furosemide - 40mg 40mg Tablet 166,381 L.L
B03BB01 FOLICIL G Folic acid - 5mg 5mg Tablet 584,571 L.L
C10AB05 FENOFIBRATE ARROW G Fenofibrate - 160mg 160mg Tablet 639,669 L.L
N02BE01 FEBRADOL G Paracetamol - 500mg 500mg Tablet 327,642 L.L
N02BE01 FEBRADOL JOINT G Paracetamol - 665mg 665mg Tablet 289,246 L.L
G01AC05 FLUOMIZIN B Dequalinium chloride - 10mg 10mg Tablet 775,397 L.L
J02AC01 FLUZAN 50 G Fluconazole - 50mg 50mg Tablet 719,276 L.L
J02AC01 FLUZAN G Fluconazole - 150mg 150mg Tablet 231,653 L.L
J01AA02 FARMODOXI G Doxycycline (hyclate) - 100mg 100mg Tablet 310,428 L.L
M05BA04 FOSAMAX 70MG ONCE WEEKLY B Alendronate - 70mg 70mg Tablet 1,988,887 L.L
V03AE03 FOSRENOL B Lanthanum Carbonate - 500mg 500mg Tablet, chewable 18,751,847 L.L
V03AE03 FOSRENOL B Lanthanum Carbonate - 750mg 750mg Tablet, chewable 24,138,283 L.L
R05CB01 FLUIMUCIL B N-acetylcysteine - 600mg 600mg Tablet, effervescent 567,102 L.L
A10BD20 FLORIMET 12.5/1000 G Metformin - 1000mg, Empagliflozin - 12.5mg Tablet, film coated 1,836,585 L.L
A10BD20 FLORIMET 5/1000 G Metformin - 1000mg, Empagliflozin - 5mg Tablet, film coated 1,836,585 L.L
A02BA03 FAMODAR 20 G Famotidine - 20mg 20mg Tablet, film coated 552,319 L.L
A02BA03 FAMONOR G Famotidine - 20mg 20mg Tablet, film coated 220,390 L.L
A02BA03 FAMODAR 40 G Famotidine - 40mg 40mg Tablet, film coated 552,319 L.L
A02BA03 FAMONOR G Famotidine - 40mg 40mg Tablet, film coated 439,436 L.L
P01AB01 FLAGYL B Metronidazole - 500mg 500mg Tablet, film coated 310,428 L.L
P01AB01 FLAGYL B Metronidazole - 250mg 250mg Tablet, film coated 176,043 L.L
V03AE02 FOSEAL-800 G Sevelamer HCl - 800mg 800mg Tablet, film coated 470,345 L.L
V03AE02 FOSEAL-800 G Sevelamer HCl - 800mg 800mg Tablet, film coated 7,977,094 L.L
A10BK01 FORXIGA B Dapagliflozin - 10mg 10mg Tablet, film coated 2,927,964 L.L
A10BK03 FLORIANCE 25 G Empagliflozin - 25mg 25mg Tablet, film coated 1,791,790 L.L
A10BK03 FLORIANCE 10 G Empagliflozin - 10mg 10mg Tablet, film coated 1,791,790 L.L
L02BG04 FEMARA B Letrozole - 2.5mg 2.5mg Tablet, film coated 3,433,518 L.L
L02BG04 FEMAPLEX G Letrozole - 2.5mg 2.5mg Tablet, film coated 1,583,046 L.L
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