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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
J01CA01 ANTALPEN G Ampicillin (trihydrate) - 125mg/5ml 125mg/5ml Powder for suspension 174,060 L.L
J01CA01 AMPICILLIN G Ampicillin (trihydrate) - 250mg/5ml 250mg/5ml Powder for suspension 206,056 L.L
J01CA01 ANTALPEN FORTE G Ampicillin (trihydrate) - 250mg/5ml 250mg/5ml Powder for suspension 206,056 L.L
J01FA10 AZOMYCIN G Azithromycin (dihydrate) - 200mg/5ml 200mg/5ml Powder for suspension + solvent 365,525 L.L
S02CA06 AURICULARUM G Dexamethasone (sodium phosphate) - 10mg, Nystatin - 1,000,000IU, Oxytetracycline HCl - 90,000IU, Polymyxin B sulfate - 100,000IU Powder for suspension + solvent 755,239 L.L
R05X ACTISOUFRE B Sulfure de Sodium - 13mg, Saccharomyces Cerevisiae - 500mg Solution 740,457 L.L
R06AX27 AERIUS B Desloratadine - 0.5mg/ml 0.5mg/ml Solution 403,153 L.L
D11AX01 ALOPEXY G Minoxidil - 20mg/ml 2% Solution 532,162 L.L
D11AX01 ALOPEXY G Minoxidil - 2% 2% Solution 532,162 L.L
D11AX01 ALOPEXY G Minoxidil - 50mg/ml 5% Solution 896,343 L.L
D11AX01 ALOPEXY G Minoxidil - 5% 5% Solution 896,343 L.L
R01AD09 AVOCOM G Mometasone furoate - 0.05% 0.05% Spray 419,279 L.L
R02A ANGINOVAG G Lidocaine HCl - 100mg/100ml, Hydrocortisone acetate - 60mg/100ml, Tyrothricin - 400mg/100ml, Dequalinium chloride - 100mg/100ml, β-Glycerrhetinic acid - 60mg/100ml Spray 651,764 L.L
D04AB01 AVOCAINE G Lidocaine - 10% 10% Spray 400,465 L.L
R01AC03 ALLERGODIL NASAL B Azelastine HCl - 0.14mg/dose 0.14mg/dose Spray, solution 657,139 L.L
A07EC02 ASACOL B Mesalazine - 500mg 500mg Suppository 1,703,992 L.L
M01AE02 ANODYNE 500 G Naproxen - 500mg 500mg Suppository 342,680 L.L
N02BE01 ADOL G Paracetamol - 250mg 250mg Suppository 124,977 L.L
N02BE01 ALGIVIC G Paracetamol - 250mg 250mg Suppository 215,015 L.L
N02BE01 ADOL G Paracetamol - 500mg 500mg Suppository 131,697 L.L
N02BE01 ALGIVIC G Paracetamol - 500mg 500mg Suppository 147,183 L.L
N02BE01 ADOL G Paracetamol - 125mg 125mg Suppository 107,507 L.L
N02BE01 ALGIVIC INFANT G Paracetamol - 125mg 125mg Suppository 199,657 L.L
R03DA05 AMINOPHYLLINE ADULTS G Aminophylline - 350mg 350mg Suppository 244,451 L.L
R03DA05 AMINOPHYLLINE CHILDREN G Aminophylline - 100mg 100mg Suppository 203,496 L.L
N02BE51 ALGIN ADULTS G Paracetamol - 400mg, Caffeine - 50mg Suppository 195,817 L.L
A02AF02 ACTONORM B Aluminium hydroxide - 220mg/5ml, Magnesium hydroxide - 200mg/5ml, Simethicone - 25mg/5ml Suspension 425,998 L.L
P02CA03 ALBENDA G Albendazole - 100mg/5ml 400mg/20ml Suspension 129,009 L.L
R01AD12 AVAMYS B Fluticasone furoate - 27.5mcg/dose 27.5mcg/dose Suspension 722,987 L.L
R01AD12 AVAMYS B Fluticasone furoate - 27.5mcg/dose 27.5mcg/dose Suspension 722,987 L.L
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