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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
L01EF01 PAPILLIO G Palbociclib - 125mg 125mg Capsule, hard 147,883,080 L.L
A02BC04 PRASOLAN G Rabeprazole sodium - 20mg 20mg Tablet, enteric coated 230,373 L.L
A02BC04 PULOROS 28 G Rabeprazole sodium - 20mg 20mg Tablet, gastroresistant 706,861 L.L
J01MA12 PILOQ G Levofloxacin - 500mg/100ml 500mg/100ml Injectable solution 980,365 L.L
C10AA07 PMS-ROSUVASTATIN G Rosuvastatin (calcium) - 20mg 20mg Tablet 564,414 L.L
C10AA07 PREVAST 20-IPS G Rosuvastatin (calcium) - 20mg 20mg Tablet, film coated 639,925 L.L
N02AJ06 PARACO-DENK 1000/60 G Paracetamol - 1000mg, Codeine phosphate hemihydrate - 60mg Suppository 636,981 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 2,822,386 L.L
N06AB06 PMS-SERTRALINE G Sertraline HCl - 100mg 100mg Capsule 2,015,764 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 7.46g/100ml 7.46g/100ml Injectable solution 663,077 L.L
L01BA04 PEMETREXED NEAPOLIS G Pemetrexed (disodium) - 500mg Injectable powder L.L
G04BX14 PRIXETIN 30 G Dapoxetine (hydrochloride) - 30mg 30mg Tablet, film coated 2,105,353 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 10g/100ml 10g/100ml Injectable solution 3,023,493 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 15g/100ml 15g/100ml Injectable solution 5,688,441 L.L
A11CC05 PEDIAVIT D G Vitamin D3 - 400IU 400IU Liquid 550,975 L.L
B05XA01 POTASSIUM CHLORIDE G Potassium chloride - 11.2g/100ml 11.2g/100ml Injectable solution 789,487 L.L
G04BX14 PRIXETIN 60 G Dapoxetine (hydrochloride) - 60mg Tablet, film coated 1,479,123 L.L
L01EF01 PAPILLIO G Palbociclib - 125mg 125mg Capsule, hard L.L
A02BC05 PRIMAZOL 20 G Esomeprazole (magnesium dihydrate) - 20mg 20mg Capsule, gastro-resistant 511,940 L.L
C07AA05 PROBETOL G Propranolol HCl - 10mg 10mg Tablet 126,705 L.L
A11CC05 PEDIAVIT D 800 G Vitamin D3 - 800IU 800IU Liquid 580,540 L.L
C07AA05 PROBETOL G Propranolol HCl - 40mg 40mg Tablet 159,981 L.L
G04CA01 PROSTETROL G Alfuzosin HCl - 10mg 10mg Tablet, modified release 360,150 L.L
G04CA01 PROSTETROL G Alfuzosin HCl - 10mg 10mg Tablet, modified release 682,672 L.L
N06AB10 PRAMACYT 10 G Escitalopram (oxalate) - 10mg 10mg Tablet, film coated 767,910 L.L
N06AB10 PRYLEX 10 G Escitalopram (oxalate) - 10mg 10mg Tablet, film coated 767,910 L.L
C10AA08 PIVAL G Pitavastatin - 2mg 2mg Tablet 802,466 L.L
G04CA02 PROSTAFINE G Tamsulosin HCl - 0.4mg 0.4mg Capsule, modified release 761,511 L.L
R03AK06 PROPIONATE DE FLUTICASONE/ SALMETEROL ARROW G Salmeterol - 50mcg/dose, Fluticasone propionate - 100mcg/dose Inhalation powder 1,593,797 L.L
C10AA08 PIVAL G Pitavastatin - 4mg 4mg Tablet 1,265,772 L.L
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