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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
J01DD08 SUPRAX B Cefixime (trihydrate) - 400mg 400mg Capsule 2,053,391 L.L
J01DD08 SUPRAX B Cefixime (trihydrate) - 400mg 400mg Capsule 2,053,391 L.L
N05AL05 SOLIAN B Amisulpride - 400mg 400mg Tablet, film-scored 1,764,465 L.L
B05XA02 SODIUM BICARBONATE G Sodium bicarbonate - 4.2g/100ml 4.2g/100ml Injectable solution 742,370 L.L
D10AF02 SPOTEX G Erythromycin - 4% 4% Gel 854,684 L.L
A07BC05 SMECTALIA B Diosmectite - 3g/sachet 3g/sachet Powder for suspension 935,570 L.L
A07BC05 SMECTALIA STRAWBERRY B Diosmectite - 3g/sachet 3g/sachet Powder for suspension 935,570 L.L
A07EC02 SALOFALK B Mesalazine - 3g 3g Granules, gastro-resistant, prolonged release 11,256,652 L.L
G04BD09 SPASMEX B Trospium chloride - 30mg 30mg Tablet, film coated 2,564,051 L.L
G04BD09 SPASMEX B Trospium chloride - 30mg 30mg Tablet, film coated 2,564,051 L.L
H01CB02 SANDOSTATIN LAR B Octreotide (acetate) - 30mg 30mg Injectable powder for suspension+diluent L.L
H01CB02 SANDOSTATIN LAR B Octreotide (acetate) - 30mg 30mg Injectable powder for suspension+diluent 57,182,544 L.L
M01AE11 SURGAM B Tiaprofenic acid - 300mg 300mg Tablet 849,308 L.L
J01DD15 SEFARIN G Cefdinir - 300mg 300mg Capsule 1,494,353 L.L
N05AH04 SEROPINE XR 300 G Quetiapine fumarate - 300mg 300mg Tablet, extended release 4,744,660 L.L
A04AA02 SANCUSO G Granisetron - 3.1mg/24h 3.1mg/24h Patch 7,590,728 L.L
N01BB03 SCANDONEST 3% sans vasoconstricteur B Mepivacaine - 54mg/1.8ml 3% Injectable solution 1,670,396 L.L
N01BB03 SCANDINIBSA G Mepivacaine HCl - 3% 3% Injectable solution 1,191,988 L.L
J02AC01 STABILANOL G Fluconazole - 2mg/ml 2mg/ml Injectable solution 1,291,789 L.L
R03AC02 SALBUTAMOL SULFATE G Salbutamol (sulfate) - 2mg 2mg Tablet, scored 401,873 L.L
M03BX02 SIRDALUD B Tizanidine HCl - 2mg 2mg Tablet 659,104 L.L
A03AX13 SIMETHICONE G Dimethicone - 2g/100ml 2g/100ml Emulsion 212,327 L.L
P01AB07 SECNOL G Secnidazole anhydre - 2g 2g Granules 842,589 L.L
P01AB07 SECNOL G Secnidazole - 2g 2g Granules 842,589 L.L
N06AX27 SPRAVATO B Esketamine - 28mg/device 28mg/device Solution 25,122,440 L.L
N06AX27 SPRAVATO B Esketamine (HCl) - 28mg 28mg/device Solution 66,978,978 L.L
N06AX27 SPRAVATO B Esketamine (HCl) - 28mg 28mg/device Solution 44,561,381 L.L
N06AX27 SPRAVATO B Esketamine (HCl) - 28mg 28mg/device Solution 25,122,440 L.L
N03AX09 SEIZET 25 G Lamotrigine - 25mg 25mg Tablet, dispersible/ chewable 573,821 L.L
N06AB05 SEROXAT CR B Paroxetine (HCl) - 25mg 25mg Tablet, controlled release 2,845,587 L.L
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