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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
C09BX01 TRIPLIXAM B Perindopril arginine - 10mg, Indapamide - 2.5mg, Amlodipine - 10mg Tablet, film coated 1,315,622 L.L
D07AC14 ADVANTAN B Methylprednisolone aceponate - 1mg/g 1mg/g Cream 385,683 L.L
R05X FERVEX CHILDREN SUGAR FREE B Paracetamol - 280mg, Ascorbic acid - 100mg, Pheniramine maleate - 10mg Granules for solution 425,998 L.L
A07BA01 BIOCARBON B Activated charcoal - 250mg 250mg Tablet 1,361,312 L.L
A10BH05 TRAJENTA B Linagliptin - 5mg 5mg Tablet, film coated 3,213,127 L.L
B01AX05 ARIXTRA B Fondaparinux sodium - 2.5mg/0.5ml 2.5mg/0.5ml Injectable solution 5,341,774 L.L
C09BX02 COSYREL B Perindopril arginine - 5mg, Bisoprolol fumarate - 5mg Tablet, film coated, scored 749,864 L.L
J01CR02 AUGMENTIN B Amoxicillin (trihydrate) - 400mg/5ml, Clavulanic Acid (potassium) - 57mg/5ml 457mg/5ml Powder for suspension 524,099 L.L
N01AH06 ULTIVA B Remifentanil (HCl) - 2mg 2mg Injectable powder for solution 1,632,769 L.L
N03AX09 LAMICTAL B Lamotrigine - 25mg 25mg Tablet 1,088,270 L.L
N05BA08 LEXOTANIL B Bromazepam - 1.5mg 1.5mg Tablet, scored 299,677 L.L
R05X FERVEX ADULTS SUGAR FREE B Paracetamol - 500mg, Ascorbic acid - 200mg, Pheniramine maleate - 25mg Granules for solution 425,998 L.L
A07BA51 CARBOSYLANE B Simethicone (blue-red) - 45mg (blue-red), Activated charcoal (blue-red) - 140mg (blue-red) Capsule 585,915 L.L
B01AX05 ARIXTRA B Fondaparinux sodium - 7.5mg/0.6ml 7.5mg/0.6ml Injectable solution 12,004,668 L.L
C03CA01 LASIX B Furosemide - 40mg 40mg Tablet 120,946 L.L
C09BX02 COSYREL B Perindopril arginine - 10mg, Bisoprolol fumarate - 5mg Tablet, film coated, scored 749,864 L.L
D07AC18 PEITEL B Prednicarbate - 0.25% 0.25% Cream 507,972 L.L
L02BB03 CASODEX B Bicalutamide - 50mg 50mg Tablet, film coated 3,777,541 L.L
M01AB05 DIVIDO 75MG B Diclofenac sodium - 75mg 75mg Capsule, dual release 502,597 L.L
P02CA01 VERMOX B Mebendazole - 100mg/5ml 100mg/5ml Suspension 223,078 L.L
R05X FERVEX ADULTS RASPBERRY B Paracetamol - 500mg, Ascorbic acid - 200mg, Pheniramine maleate - 25mg Granules for solution 425,998 L.L
V03AE01 CALCIUM RESONIUM B Calcium Polystyrene Sulphonate - 15g 15g Powder 2,053,391 L.L
A07BA51 EUCARBON B Rhubarbe - 25mg, Sulfur - 50mg, Senna - 105mg, Vegetal charcoal - 180mg Tablet 795,555 L.L
B02AA02 EXACYL B Tranexamic acid - 500mg/5ml 500mg/5ml Injectable solution 748,520 L.L
C09CA01 COZAAR B Losartan potassium - 50mg 50mg Tablet 1,420,634 L.L
D07AD01 DERMOVATE B Clobetasol (propionate) - 0.5mg/g 0.05% w/w Cream 290,270 L.L
G04BD09 SPASMEX B Trospium chloride - 30mg 30mg Tablet, film coated 2,564,051 L.L
N01AX10 PROPOFOL-LIPURO B Propofol - 10mg/ml 1% Injectable emulsion 1,411,035 L.L
N05BA12 XANAX B Alprazolam - 0.5mg 0.5mg Tablet 477,064 L.L
P02CA01 VERMOX B Mebendazole - 500mg 500mg Tablet 106,164 L.L
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