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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
C07AB07 BISOPROLOL NORMON G Bisoprolol hemifumarate - 1.25mg 1.25mg Tablet, film coated 167,980 L.L
J01DB05 BIODROXIL G Cefadroxil (monohydrate) - 1000mg 1,000mg Tablet, film coated 1,091,442 L.L
L01FB01 BESPONSA FOR INJECTION BioTech Inotuzumab Ozogamicin - 0.9mg 0.9mg Injectable powder for suspension 921,176,511 L.L
L01FB01 BESPONSA FOR INJECTION BioTech Inotuzumab Ozogamicin - 0.9mg 0.9mg Injectable powder for suspension L.L
D02AX BIAFINE B Trolamine - 0.67g/100g 0.67g/100g Emulsion 524,099 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
R03BA02 BUDESONIDE ARROW G Budesonide - 0.5mg/2ml 0.5mg/2ml Inhalation suspension for nebuliser 1,342,499 L.L
S01EA05 BGLAU G Brimonidine tartrate - 0.2% 0.20% Drops solution 638,325 L.L
S01EA05 BRIMO G Brimonidine tartrate - 0.2% 0.20% Drops solution 658,483 L.L
S01EA05 BRIMONIDINE BIOGARAN G Brimonidine tartrate - 2mg/ml 0.20% Drops solution 412,560 L.L
S01EA05 BRIMOGAN G Brimonidine tartrate - 0.2% w/v 0.2% w/v Drops solution 483,783 L.L
D07AC01 BETNOVATE B Betamethasone - 0.1% 0.10% Solution 235,172 L.L
D07AC01 BETNOVATE B Betamethasone (valerate) - 0.1% 0.1% w/w Cream 279,519 L.L
D07AC01 BETNOVATE B Betamethasone (valerate) - 0.1% 0.1% w/w Ointment 279,519 L.L
D03AX06 BECAPLEX BioTech Becaplermin - 40mg 0.01% Gel 38,029,953 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 5mg, Indapamide - 1.25mg Tablet, film coated 452,875 L.L
C09BA04 BI-PRETERAX ARGININE B Perindopril arginine - 10mg, Indapamide - 2.5mg Tablet, film coated 765,990 L.L
R05FB BRONCHOPHANE G Dextrometorphan HBr - 4.58mg/5ml, Diphenydramine HCl - 5mg/5ml, Ephedrine HCl - 7.5mg/5ml, Guaifenesin - 50mg/5ml Syrup 115,570 L.L
J05AR20 BIKTARVY B Bictegravir - 50mg, Emtricitabine - 200mg, Tenofovir alafenamide - 25mg Tablet, film coated 76,569,138 L.L
R05X BROMEX G Pyrilamine Maleate (Mepyramine) - 12.5mg/5ml, Bromhexine HCl - 4mg/5ml Elixir 250,851 L.L
J01CR02 BETAMOX ES G Amoxicillin - 600mg/5ml, Clavulanic Acid - 42.9mg/5ml Powder for suspension 592,635 L.L
D07CC01 BETAFUCIN G Fusidic acid - 20mg/g, Betamethasone valerate - 1mg/1g Cream 210,983 L.L
D07CC01 BETASONE-N G Neomycin (sulfate) - 3.5mg/g, Betamethasone (valerate) - 1mg/g Cream 398,033 L.L
D07XC01 BETA-MICOTER G Betamethasone (dipropionate) - 0.5mg/g, Clotrimazole - 10mg/g Cream 415,951 L.L
M01AC01 BRUXICAM B Piroxicam - 0.5% Drops solution 530,818 L.L
A11A BEBE-VIT G Vitamin A - 1500IU/ml, Vitamin D3 - 400IU/ml, Vitamin E - 5mg/ml, Vitamin C - 40mg/ml, Vitamin B1 - 0.5mg/ml, Vitamin B2 - 0.6mg/ml, Vitamin B6 - 0.6mg/ml, Nicotinamide - 8mg/ml Drops 287,582 L.L
J07AJ51 BOOSTRIX B Diphteria toxoid purified - ?2.5Lf/0.5ml, Tetanus toxoid purified - ?5Lf/0.5ml, Bordetella Pertussis Antigens: toxoid - 8mcg/0.5ml, Bordetella Pertussis Antigens: filamentous haemagglutinin - 8mcg/0.5ml, Pertactine - 2.5mcg Al3+/0.5ml, Aluminium hydroxide - 0.3mg Al3+/0.5ml, Aluminium Phosphate - 0.2mg/0.5ml Injectable suspension 1,394,909 L.L
J07AX BRONCHO-VAXOM CHILDREN B Lyophilized bacterial lysates of Haemophilus influenzae, Diplococcus pneumoniae, Klebsiella pneumoniae and ozaenae, Staphylococcus aureus, Streptococcus pyogenes and viridans, Neisseria catarrhalis - 3.5mg Capsule 1,988,887 L.L
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
L03AX03 BCG-MEDAC G BCG seed RIVM derived from seed 1173-P2 - 2x10? to 3x10? viable units Injectable powder for suspension+diluent 13,873,850 L.L
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