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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
N02AB03 DUROGESIC B Fentanyl - 16.8mg 100mcg/h Patch 5,911,563 L.L
G03HB01 DIANE '35' B Ethinylestradiol - 0.035mg, Cyproterone acetate - 2mg Tablet 494,534 L.L
B02BX01 DICYNONE B Etamsylate - 500mg 500mg Capsule 1,311,590 L.L
B02BX01 DICYNONE B Etamsylate - 250mg/2ml 250mg Injectable solution 482,439 L.L
G03DB01 DUPHASTON B Dydrogesterone - 10mg 10mg Tablet, film coated 935,314 L.L
G04CB02 DUTASTERIDE ARROW LAB G Dutasteride - 0.5mg 0.5mg Capsule 1,166,455 L.L
G04CB02 DUTASTERIDE BIOGARAN G Dutasteride - 0.5mg 0.5mg Capsule, soft 1,112,702 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 300mg 300mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
D11AH05 DUPIXENT BioTech Dupilumab - 200mg 200mg Injectable solution 123,001,362 L.L
N06AX21 DULOXA 60 G Duloxetine HCl - 60mg 60mg Capsule, delayed release 831,903 L.L
N06AX21 DULOXETINE BIOGARAN G Duloxetine HCl - 60mg 60mg Capsule, gastro-resistant 573,821 L.L
N06AX21 DULOXA 30 G Duloxetine HCl - 30mg 30mg Capsule, delayed release 716,716 L.L
N06AX21 DULOXETINE BIOGARAN G Duloxetine HCl - 30mg 30mg Capsule, gastro-resistant 573,821 L.L
R05CB10 DILAMUC G Dried Ivy leaf extract - 170mg/100ml, Glycyrrhizic acid (Glycyrrhiza Glabra, Liquorice root) - 164mg/100ml, Thyme - 760mg/100ml Syrup 456,906 L.L
J01AA02 DOXY 50 G Doxycycline (hyclate) - 50mg 50mg Tablet, coated 311,771 L.L
J01AA02 DOXY 100 G Doxycycline (hyclate) - 100mg 100mg Tablet, coated 788,836 L.L
J01AA02 DOXYLAG G Doxycycline (hyclate) - 100mg 100mg Capsule 174,700 L.L
L01DB01 DOXO-CELL G Doxorubicin HCl - 50mg/25ml 50mg/25ml Injectable solution 1,794,030 L.L
L01DB01 DOXORUBICINA PHARMINICIO G Doxorubicin HCl - 50mg/25ml 50mg/25ml Injectable concentrate for solution 2,015,764 L.L
L01DB01 DOXORUBICINE EBEWE G Doxorubicin HCl - 2mg/ml 50mg/25ml Injectable concentrated solution 1,804,780 L.L
L01DB01 DOXORUBICINE EBEWE G Doxorubicin HCl - 10mg/5ml 10mg/5ml Injectable concentrated solution 428,686 L.L
N06AA12 DOXEPIN HCl G Doxepin (HCl) - 50mg 50mg Capsule 965,007 L.L
D04AX01 DOXIDERM G Doxepin (HCl) - 5% 5% Cream 1,037,958 L.L
N06AA12 DOXEPIN HCl G Doxepin (HCl) - 10mg 10mg Capsule 712,876 L.L
S01EC03 DORZOLAMIDE BGR G Dorzolamide HCl - 20mg/ml 20mg/ml Drops solution 517,379 L.L
C01CA04 DOPAMINE FRESENIUS G Dopamine HCl - 200mg/5ml 200mg/5ml Injectable concentrated solution 713,580 L.L
C01CA04 DOPAMINE RENAUDIN G Dopamine HCl - 200mg/5ml 4% Injectable concentrated solution 1,107,326 L.L
N06DA02 DONECEPT 5 G Donepezil HCl - 5mg 5mg Tablet, film coated 1,970,969 L.L
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