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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
J07AX BRONCHO-VAXOM ADULTS B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 7mg Capsule 2,746,814 L.L
A03AA04 BEVACOL 135 G Mebeverine HCl - 135mg 135mg Tablet, film coated 532,162 L.L
A10BA02 BROT G Metformin HCl - 850mg 850mg Tablet, film coated 327,898 L.L
C07AB02 BETALOC ZOK B Metoprolol succinate - 25mg 25mg Tablet, controlled release 219,046 L.L
C07AB02 B-BLOK SDK G Metoprolol succinate - 25mg 25mg Tablet, controlled release 282,207 L.L
C07AB02 BETALOC ZOK B Metoprolol succinate - 50mg 50mg Tablet, controlled release 491,846 L.L
C07AB02 B-BLOK SDK G Metoprolol succinate - 50mg 50mg Tablet, controlled release 295,645 L.L
G04BD12 BETMIGA B Mirabegron - 50mg 50mg Tablet, prolonged release 3,758,727 L.L
C07AB12 BLOVEK G Nebivolol HCl - 5mg Tablet 511,940 L.L
D07CC01 BETASONE-N G Neomycin (sulfate) - 3.5mg/g, Betamethasone (valerate) - 1mg/g Cream 398,033 L.L
D06AX BATRAMYCIN B Neomycin (sulfate) - 5000IU/g, Bacitracin - 250IU/g Ointment 249,955 L.L
D06AX BANEOCIN B Neomycin sulfate - 5000IU/g, Bacitracin zinc - 250IU/g Ointment 173,356 L.L
A11EX BECOZYM FORTE B Nicotinamide - 50mg, Calcium Pantothenate - 25mg, Biotin - 0.15mg, Vitamin B12 - 10mcg, Vitamin B6 - 10mg, Vitamin B2 - 15mg, Vitamin B1 - 15mg Capsule 290,270 L.L
B02BD04 BENEFIX BioTech Nonacog alfa (recombinant coagulation factor IX) - 500IU 500IU Injectable powder for solution+diluent 27,390,281 L.L
B02BD04 BENEFIX BioTech Nonacog alfa (recombinant coagulation factor IX) - 500IU 500IU Injectable powder for solution+diluent L.L
N05AX13 BYANNLI B Paliperidone - 1000mg 1000mg Injectable suspension, prolonged release 141,224,257 L.L
N05AX13 BYANNLI B Paliperidone - 700mg 700mg Injectable suspension, prolonged release 96,913,176 L.L
N02BE01 BBDOL-OR G Paracetamol - 120mg/5ml 120mg/5ml Syrup 188,138 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 10mg, Indapamide - 2.5mg Tablet, film coated 765,990 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 5mg, Indapamide - 1.25mg Tablet, film coated 452,875 L.L
M01AC01 BRUXICAM B Piroxicam - 0.5% Drops solution 530,818 L.L
M01AC01 BREXIN B Piroxicam-?-cyclodextrin - 20mg 20mg Tablet, scored 971,598 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 100mg/2ml 100mg/2ml Injectable solution 2,328,879 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 200mg 200mg Pessary 1,804,780 L.L
G03DA04 BIOGEST BioTech Progesterone, bio-identical - 400mg 400mg Pessary 1,083,137 L.L
C07AA05 BEDRANOL G Propranolol HCl - 10mg 10mg Tablet, film coated 247,267 L.L
C07AA05 BEDRANOL G Propranolol HCl - 40mg 40mg Tablet, film coated 247,267 L.L
R05X BROMEX G Pyrilamine Maleate (Mepyramine) - 12.5mg/5ml, Bromhexine HCl - 4mg/5ml Elixir 250,851 L.L
R03AC02 BUTALIN G Salbutamol (sulfate) - 100mcg/dose 100mcg/dose Inhalation aerosol metered dose 145,135 L.L
R03AK13 BUTOSOL G Salbutamol (sulfate) - 100mcg/dose, Beclometasone dipropionate - 50mcg/dose Metered dose inhaler 548,288 L.L
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