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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
A10AE54 SULIQUA BioTech Insulin glargine - 100IU/ml, Lixisenatide - 50mcg/ml Injectable solution 11,286,573 L.L
D11AX22 SOOLANTRA B Ivermectin - 10mg/g 10mg/g Cream 2,154,180 L.L
D11AX22 SOOLANTRA B Ivermectin - 10mg/g 10mg/g Cream 1,053,573 L.L
M01AE03 SOLKET INFLAMMATION AND PAIN G Ketoprofen Lysine salt - 0.16% 0.16% Spray 946,065 L.L
M01AE03 SOLKET G Ketoprofen Lysine salt - 80mg 80mg Powder for solution 636,981 L.L
A06AD61 SOFLAX G Lactose - less than 6g/100ml, Galactose - less than 11g/100ml, Lactulose - 67g/100ml Solution 258,018 L.L
N03AX09 SEIZET 25 G Lamotrigine - 25mg 25mg Tablet, dispersible/ chewable 573,821 L.L
H01CB03 SOMATULINE AUTOGEL B Lanreotide (acetate) - 120mg 120mg Injectable solution 57,492,826 L.L
H01CB03 SOMATULINE AUTOGEL B Lanreotide (acetate) - 120mg 120mg Injectable solution L.L
H01CB03 SOMATULINE AUTOGEL B Lanreotide (acetate) - 90mg 90mg Injectable solution 48,383,450 L.L
L04AX04 SOTIRA G Lenalidomide - 10mg 10mg Capsule 72,248,183 L.L
L04AX04 SOTIRA G Lenalidomide - 15mg 15mg Capsule 76,208,289 L.L
L04AX04 SOTIRA G Lenalidomide - 25mg 25mg Capsule 76,719,234 L.L
L04AX04 SOTIRA G Lenalidomide - 5mg 5mg Capsule 68,908,116 L.L
N04BA02 SINEMET B Levodopa - 100mg, Carbidopa - 25mg Tablet 2,742,335 L.L
N04BA02 SINEMET B Levodopa - 250mg, Carbidopa - 25mg Tablet, scored 1,283,690 L.L
A10BJ02 SAXENDA BioTech Liraglutide - 6mg/ml 6mg/ml Injectable solution 16,747,035 L.L
B05XA05 SULFATE DE MAGNESIUM PROAMP G Magnesium sulfate - 0.15g/ml 0.15g/ml Injectable solution 1,400,284 L.L
B05XA05 SULFATE DE MAGNESIUM RENAUDIN G Magnesium sulfate - 1.5g/10ml 15% Injectable solution 434,061 L.L
B05BC01 SERUFLEX MANNITOL 20% INJECTION, USP G Mannitol - 20g/100ml 20g/100ml Injectable solution 402,213 L.L
B05BC01 SOLUFLEX MANNITOL 20% INJECTION, USP G Mannitol - 20g/100ml 20g/100ml Injectable solution 603,320 L.L
A03AA04 SPASMINE (Mebeverine HCl 200mg SR) G Mebeverine HCl - 200mg 200mg Capsule, slow release 712,876 L.L
N01BB03 SCANDONEST 3% sans vasoconstricteur B Mepivacaine - 54mg/1.8ml 3% Injectable solution 1,670,396 L.L
N01BB03 SCANDINIBSA G Mepivacaine HCl - 3% 3% Injectable solution 1,191,988 L.L
A07EC02 SALOFALK B Mesalazine - 1.5g 1.5g Granules, gastro-resistant, prolonged release 6,150,767 L.L
A07EC02 SALOFALK B Mesalazine - 1000mg 1000mg Granules, gastro-resistant, prolonged release 3,874,298 L.L
A07EC02 SALCROZINE G Mesalazine - 1000mg 1000mg Suppository 2,306,034 L.L
A07EC02 SALCROZINE G Mesalazine - 1g 1g Tablet, gastroresistant 4,073,187 L.L
A07EC02 SALOFALK B Mesalazine - 1g 1g Suppository 3,948,209 L.L
A07EC02 SALOFALK B Mesalazine - 3g 3g Granules, gastro-resistant, prolonged release 11,256,652 L.L
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