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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
N06AX11 MIRTA TAD G Mirtazapine - 30mg 30mg Tablet, film coated 1,138,235 L.L
J01RA MEDSPIRAGYL G Metronidazole - 125mg, Spiramycin - 750,000IU Tablet, scored 474,824 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 500mg 500mg Tablet, film coated 193,513 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 500mg 500mg Tablet, film coated 560,382 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 500mg 500mg Tablet, film coated 193,513 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) (Vial) - 500mg, Lidocaine (ampoule) - 500mg Injectable powder for solution+diluent 307,740 L.L
D11AX01 MINOXIDIL BAILLEUL G Minoxidil - 2% 2% Solution 2,839,539 L.L
J01DD04 MEGION-A G Ceftriaxone - 0.5g/2ml, Lidocaine (ampoule) - 0.5g/2ml Injectable powder + solvent 355,840 L.L
D11AX01 MINOXIDIL BAILLEUL G Minoxidil - 5% 5% Solution 3,675,409 L.L
L01BA01 METHOTREXAT EBEWE G Methotrexate - 500mg 500mg Injectable solution 1,842,408 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 850mg 850mg Tablet, film coated 237,860 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 850mg 850mg Tablet, film coated 689,391 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 850mg 850mg Tablet, film coated 237,860 L.L
A10BA02 MET-FORTE G Metformin HCl - 850mg 850mg Tablet 355,798 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 1000mg 1000mg Tablet, film coated, scored 237,860 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 1000mg 1000mg Tablet, film coated, scored 689,391 L.L
S01AE07 MOXITEC G Moxifloxacin (HCl) - 5mg/ml 5mg/ml Drops solution 464,970 L.L
A10BA02 METFORMINE ARROW LAB G Metformin - 1000mg 1000mg Tablet, film coated, scored 237,860 L.L
A10BA02 MINOR G Metformin HCl - 1g 1g Tablet 266,209 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) - 1g 1g Injectable powder for solution+diluent 438,093 L.L
J01DD04 MEDAXONUM G Ceftriaxone (disodium) - 1g 1g Injectable powder for solution 15,482,229 L.L
J01DD04 MEGION-A G Ceftriaxone - 1g/3.5ml, Lidocaine (ampoule) - 1g/3.5ml Injectable powder + solvent 623,468 L.L
J01DD04 MESPORIN-1000 IM G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
A12CC MAVIT G Magnesium - 100mg, Pyridoxine HCl - 10mg Tablet 654,003 L.L
J01DD04 MESPORIN-1000 IV G Ceftriaxone (sodium) - 1g 1,000mg Injectable powder for solution+diluent 417,935 L.L
G01AF02 MICOTER GYNO OVULE G Clotrimazole - 500mg 500mg Pessary 447,948 L.L
G01AF04 MYCODERM-V G Miconazole nitrate - 2% 2% Cream 361,494 L.L
D01AC02 MICONAZ G Miconazole nitrate - 20mg/g 20mg/g Gel 427,470 L.L
A10BA02 METFORKEY G Metformin HCl - 1.000mg 1.000mg Tablet, extended release 374,932 L.L
N02BE01 MAKOACHE G Paracetamol - 1000mg/100ml 10mg/ml Injectable solution 1,403,867 L.L
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