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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
J01XE01 NITROFURANTOIN G Nitrofurantoin - 100mg 100mg Tablet 972,942 L.L
C07AB12 NEBIVOLOL BIOGARAN G Nebivolol HCl - 5mg 5mg Tablet, scored 529,474 L.L
C07AB12 NEVILOC G Nebivolol HCl - 5mg 5mg Tablet 476,104 L.L
C07AB12 NIVOL G Nebivolol HCl - 5mg 5mg Tablet 590,011 L.L
R03BB04 NEUMOTROPIO G Tiotropium bromide - 10mcg 10mcg Capsule, inhalation 3,115,844 L.L
C07BB12 NIVOL PLUS G Nebivolol HCl - 5mg, Hydrochlorothiazide - 12.5mg 5mg Tablet 609,209 L.L
H02AB04 NEPHARED G Methylprednisolone sodium succinate - 40mg 40mg Injectable powder for solution 188,138 L.L
B05XA31 NUTRYELT G Zinc (gluconate) - 10000mcg/10ml, Copper (gluconate) - 300mcg/10ml, Manganese (gluconate) - 55mcg/10ml, Sodium fluoride - 950mcg/10ml, Iodine potassium iodide - 130mcg/10ml, Selenium (sodium salt) - 70mcg/10ml, Molybdenum (Sodium molybdate) - 20mcg/10ml, Chrome (chlorure) - 10mcg/10ml, Ferrous (gluconate) - 1000mcg/10ml Injectable concentrate for solution 3,483,240 L.L
H02AB04 NEPHARED G Methylprednisolone sodium succinate - 125mg 125mg Injectable powder for solution 469,001 L.L
G02CB03 NOSTIFIX G Cabergoline - 0.5mg 0.5mg Tablet 976,973 L.L
G02CB03 NOSTIFIX G Cabergoline - 0.5mg 0.5mg Tablet 248,611 L.L
A03FA03 NAUZEX G Domperidone - 10mg 10mg Tablet 258,530 L.L
A03FA03 NOVADOM G Domperidone - 10mg 10mg Tablet 278,175 L.L
G03AA12 NAJAT G Drospirenone - 3mg, Ethinylestradiol - 0.03mg Tablet, coated 417,935 L.L
A04AA01 NAUSETRON G Ondansetron (HCl dihydrate) - 8mg 8mg Tablet, scored 1,023,880 L.L
A04AA01 NOZENTRIX G Ondansetron - 8mg 8mg Tablet, film coated 1,151,865 L.L
C08CA04 NICARDIPINE ARROW G Nicardipine chlorhydrate - 10mg/10ml 10mg/10ml Injectable solution 2,590,928 L.L
C08CA04 NICARDIPINE MEDIS G Nicardipine chlorhydrate - 10mg/10ml 10mg/10ml Injectable solution 1,295,464 L.L
C08CA05 NIFELAT R G Nifedipine - 20mg 20mg Tablet, sustained release 388,370 L.L
C08CA05 NIFELAT 30 LA G Nifedipine - 30mg 30mg Tablet, prolonged release 1,007,882 L.L
C08CA05 NIFELAT 60 LA G Nifedipine - 60mg 60mg Tablet, prolonged release 1,290,089 L.L
C01CA03 NORADRENALINE NOREPINEPHRINE (tartrate) Aguettant G Norepinephrine tartrate - 2mg/ml 2mg/ml Injectable solution 1,896,162 L.L
C08CA05 NIFE-PAR G Nifedipine - 5mg/ml 5mg/ml Solution 38,120,008 L.L
C01CA03 NORADRENALINE NOREPINEPHRINE (tartrate) Aguettant G Norepinephrine tartrate - 2mg/ml 2mg/ml Injectable solution 1,896,162 L.L
C01CA03 NORADRENALINE RENAUDIN G Norepinephrine tartrate - 8mg/4ml 0.20% Injectable solution 2,000,981 L.L
C01CA03 NORADRENALINE HIKMA G Noradrenaline bitartrate - 4mg/4ml 4mg/4ml Injectable solution 1,279,338 L.L
N02BF02 NERVAX G Pregabalin - 150mg 150mg Capsule 1,955,291 L.L
N02BF02 NEUREXAL G Pregabalin - 150mg 150mg Capsule 754,856 L.L
B01AC04 NORMIGORE G Clopidogrel (Bisulfate) - 75mg 75mg Tablet, film coated 1,184,117 L.L
A04AA01 NOZAMET G Ondansetron - 8mg 8mg Film, orodispersible 6,075,448 L.L
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