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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
H01AC01 CINNATROPIN BioTech Somatropin recombinant - 10mg/1.5ml 10mg/1.5ml Injectable solution L.L
A06AB58 CITRAFLEET G Sodium picosulfate - 10mg/sachet, Magnesium oxide (light) - 3.5g/sachet, Citric acid (anhydrous) - 10.97g/sachet, Potassium - 195mg/sachet Powder for solution 1,191,988 L.L
J01FA09 CLAREM 500 G Clarithromycin - 500mg 500mg Tablet, film coated 686,704 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
G03GB02 CLOMIFERT G Clomifene citrate - 50mg 50mg Tablet 395,090 L.L
C02CA04 CURCARD G Doxazosin (mesylate) - 4mg 4mg Tablet 452,875 L.L
J01FA09 CLARIDAR DAR AL DAWA G Clarithromycin - 125mg/5ml 125mg/5ml Suspension 295,645 L.L
J05AR01 CONDINE G Lamivudine - 150mg, Zidovudine - 300mg Tablet, film coated 5,818,474 L.L
J01FA09 CLARIDAR DAR AL DAWA G Clarithromycin - 250mg/5ml 250mg/5ml Suspension 877,529 L.L
N03AG01 CONVULEX G Sodium Valproate - 50mg/ml 50mg/ml Syrup 213,671 L.L
L01EA01 CEMIVIL G Imatinib - 100mg 100mg Tablet, film coated 12,763,090 L.L
N03AG01 CONVULEX G Sodium Valproate - 300mg/ml 300mg/ml Solution 1,018,633 L.L
R05X COFEX G Paracetamol - 33.3mg/5ml, Guaifenesin - 33.3mg/5ml, Oxomemazine HCl - 1.65mg/5ml Syrup 154,542 L.L
M01AB05 CLOREN ADULTS G Diclofenac sodium - 100mg 100mg Suppository 598,970 L.L
A06AX05 CONSTIPRIDE G Prucalopride succinate - 2mg 2mg Tablet, film coated 2,956,454 L.L
N03AG01 CONVULEX RETARD G Sodium Valproate - 500mg 500mg Tablet, prolonged release 423,310 L.L
R05X COLDIN G Caffeine - 30mg, Noscapine - 10mg, Pseudoephedrine HCl - 30mg, Pyrilamine maleate (Mepyramine) - 15mg, Paracetamol - 300mg Capsule 386,515 L.L
A06AX05 CONSTIPRIDE G Prucalopride succinate - 1mg 1mg Tablet, film coated 2,015,764 L.L
M01AB05 CLOFEN G Diclofenac sodium - 75mg/3ml 75mg/3ml Injectable solution 299,677 L.L
R05X COLD-MED G Caffeine - 30mg, Noscapine - 10mg, Pseudoephedrine HCl - 30mg, Pyrilamine Maleate (Mepyramine) - 15mg, Paracetamol - 300mg Capsule 386,515 L.L
N03AG01 CONVULEX G Sodium valproate - 100mg/ml 100mg/ml Injectable solution 4,441,399 L.L
R05X COLDIN G Glyceryl guaiacolate - 15mg/5ml, Pseudoephedrine HCl - 15mg/5ml, Pyrilamine maleate - 6.25mg/5ml, Paracetamol - 120mg/5ml Syrup 386,515 L.L
R05X COLD-MED G Glyceryl guaiacolate - 15mg/5ml, Pseudoephedrine HCl - 15mg/5ml, Pyrilamine maleate - 6.25mg/5ml, Paracetamol - 120mg/5ml Syrup 386,515 L.L
R05X CODOPALM EXPECTORANT G Ipeca Tincture - 3mg, Promethazine HCl - 100mg, Potassium guaiacosulfonate - 0.9g Syrup 153,582 L.L
R05X CODOPALM EXPECTORANT G Ipeca Tincture - 3mg, Promethazine HCl - 100mg, Potassium guaiacosulfonate - 0.9g Syrup 291,806 L.L
P01BA02 CORVAQUINE G Hydroxychloroquine sulfate - 200mg 200mg Tablet, film coated 1,087,873 L.L
M01AB05 CLOREN G Diclofenac sodium - 12.5mg 12.5mg Suppository 353,239 L.L
D07AD01 CLOBEVAT G Clobetasol (propionate) - 0.05% 0.05% Cream 302,045 L.L
R05X COLDIN-H G Paracetamol - 300mg, Mepyramine maleate - 15mg, Noscapine - 10mg Capsule 386,515 L.L
D07AD01 CLOBEVAT G Clobetasol (propionate) - 0.05% 0.05% Ointment 302,045 L.L
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