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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
J01DH51 CILANEM G Imipenem anhydrous - 500mg, Cilastatin (sodium) - 500mg Injectable solution 850,652 L.L
C01EB10 CARDESINE G Adenosine - 6mg/2ml 6mg/2ml Injectable solution 563,070 L.L
G03GA05 CINNAL-f BioHuman Follitropin alfa - 900IU/1.5ml 900IU/1.5ml Injectable solution 14,826,544 L.L
G03GA05 CINNAL-f BioHuman Follitropin alfa - 450IU/0.75ml 450IU/0.75ml Injectable solution 7,372,177 L.L
D04AX CALAMINE PLUS B Diphenhydramine HCl - 0.25/100ml, Tetracaine HCl - 0.025/100ml, Zinc oxide - 8g/100ml, Calamine - 8g/100ml Lotion 177,899 L.L
R02A CHLORASEPTIC TOTAL SORE THROAT + COUGH LOZENGES WILD CHERRY G Benzocaine - 6mg, Dextromethorphan - 5mg, Menthol - 10mg Lozenge 537,537 L.L
D07AD01 CLOBEVAT G Clobetasol (propionate) - 0.05% 0.05% Ointment 302,045 L.L
G01AA10 CLINDAMYCIN G Clindamycin - 100mg 100mg Ovule 712,876 L.L
G03DA04 CYCLOGEST G Progesterone - 400mg 400mg Pessary 1,546,763 L.L
V03AE01 CALCIUM RESONIUM B Calcium Polystyrene Sulphonate - 15g 15g Powder 2,053,391 L.L
A06AB58 CITRAFLEET G Sodium picosulfate - 10mg/sachet, Magnesium oxide (light) - 3.5g/sachet, Citric acid (anhydrous) - 10.97g/sachet, Potassium - 195mg/sachet Powder for solution 1,191,988 L.L
J01DB05 CEFADRIL G Cefadroxil (monohydrate) - 250mg/5ml 250mg/5ml Powder for suspension 268,769 L.L
J01DC04 CLORACEF FORTE G Cefaclor (monohydrate) - 250mg/5ml 250mg/5ml Powder for suspension 632,950 L.L
J01DC10 CEFPROZ 250 G Cefprozil - 250mg/5ml 250mg/5ml Powder for suspension 712,237 L.L
J01DC10 CEFPROZ 250 G Cefprozil - 250mg/5ml 250mg/5ml Powder for suspension 1,343,843 L.L
J01DD08 CEFIX G Cefixime (trihydrate) - 100mg/5ml 100mg/5ml Powder for suspension 349,399 L.L
J01DD08 CEFIX G Cefixime (trihydrate) - 100mg/5ml 100mg/5ml Powder for suspension 700,142 L.L
J01DD13 CEFODOX G Cefpodoxime (proxetil) - 100mg/5ml 100mg/5ml Powder for suspension 735,082 L.L
J01DD13 CEFODOX G Cefpodoxime (proxetil) - 50mg/5ml 50mg/5ml Powder for suspension 604,729 L.L
N03AG01 CONVULEX G Sodium Valproate - 300mg/ml 300mg/ml Solution 1,018,633 L.L
D08AC52 CYTEAL Solution Antiseptique G Chlorhexidine digluconate - 0.5ml/100ml, Hexamidine - 0.1g/100ml, Chlorocresol - 0.3g/100ml Solution 376,772 L.L
D08AC52 CYTEAL Solution Antiseptique G Chlorhexidine digluconate - 0.5ml/100ml, Hexamidine - 0.1g/100ml, Chlorocresol - 0.3g/100ml Solution 641,409 L.L
R06AE07 CETIMED G Cetirizine (dihydrochloride) - 5mg/5ml 5mg/5ml Solution 415,951 L.L
R06AE09 CALIVIDA G Levocetirizine dihydrochloride - 0.5mg/ml 0.5mg/ml Solution 1,158,264 L.L
A11CC05 CHOLECALCIFEROL BIOGARAN G Vitamin D3 - 100,000UI/2ml 100,000UI Solution 115,570 L.L
D01AC01 CANESTEN B Clotrimazole - 0.01g/ml 0.01g/ml Solution 368,213 L.L
N06BX06 CEROLINE G Citicoline - 100mg/ml 100mg/ml Solution 894,615 L.L
M01AB05 CLOREN ADULTS G Diclofenac sodium - 100mg 100mg Suppository 598,970 L.L
M01AB05 CLOREN G Diclofenac sodium - 12.5mg 12.5mg Suppository 353,239 L.L
R03DA55 CAMPHO-PNEUMINE AMINOPHYLLINE ENFANTS G Eucalyptol - 0.03g, Camphre - 0.04g, Gaiacol ethyl glycolate - 0.12g, Aminophylline - 0.06g Suppository 284,127 L.L
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