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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
J01DD04 LEBACEF G Ceftriaxone - 1g 1g Injectable sterile powder for solution + lidocaine solvent 508,100 L.L
L01BC07 LEUZADA G Azacitidine - 100mg 100mg Injectable suspension 10,969,285 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lipocream 221,734 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lipocream 221,734 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lotion 201,576 L.L
D07AB02 LOCOID B Hydrocortisone butyrate - 0.1% 0.1% Lotion 201,576 L.L
D01AE16 LOCERYL B Amorolfine - 125mg/2.5ml 5% Nail lacquer 1,076,418 L.L
D04AB01 LIDONOSTRUM G Lidocaine - 50mg/g 50mg/g Ointment 1,069,699 L.L
G01AF12 LOMEXIN B Fenticonazole nitrate - 200mg 200mg Ovule 810,359 L.L
G01AF12 LOMEXIN B Fenticonazole nitrate - 600mg 600mg Ovule 850,727 L.L
G01AF12 LOMEXIN "T" B Fenticonazole nitrate - 1,000mg 1,000mg Ovule 909,037 L.L
R06AX29 LABIXTEN B Bilastine - 2.5mg/ml 2.5mg/ml Solution 463,626 L.L
N03AX14 LEPITAM G Levetiracetam - 100mg/ml 100mg/ml Solution 1,336,163 L.L
N03AX14 LEVETIRACETAM ARROW G Levetiracetam - 100mg/ml 100mg/ml Solution 1,639,488 L.L
N03AX14 LEVETRIMED G Levetiracetam - 100mg/ml 100mg/ml Solution 1,336,163 L.L
N03AX14 LEVIPRAM G Levetiracetam - 100mg/ml 100mg/ml Solution 1,285,609 L.L
D01AE15 LAMISIL B Terbinafine HCl - 10mg/ml 1% Solution 962,191 L.L
D01AE15 LAMISIL B Terbinafine HCl - 10mg/ml 1% Solution 506,629 L.L
D04AB01 LIDONOSTRUM BOMBA-SPRAY G Lidocaine - 10% 100mg/ml Spray, solution 747,176 L.L
R05CA12 LIBLAB COUGH SUPPOSITORIES G Dried Ivy leaf extract - 80mg 80mg Suppository 142,447 L.L
S01GX02 LEVOPHTA B Levocabastine HCl - 0.5mg/ml 0.05% Suspension 682,672 L.L
R05CA12 LIBLAB COUGH SYRUP G Dried Ivy leaf extract - 35mg/5ml 35mg/5ml Syrup 237,860 L.L
R06AX13 LORINE G Loratadine (micronised) - 5mg/5ml 5mg/5ml Syrup 215,015 L.L
N05AH02 LEPONEX B Clozapine - 100mg 100mg Tablet 1,975,448 L.L
N05AH02 LANOLEPT G Clozapine - 100mg 100mg Tablet 1,482,258 L.L
M03BA03 LUMIRELAX B Methocarbamol - 500mg 500mg Tablet 667,890 L.L
C03CA01 LASIX B Furosemide - 40mg 40mg Tablet 120,946 L.L
R03DC03 LEUKOTRIS G Montelukast - 10mg 10mg Tablet 981,645 L.L
C09CA01 LOSANET G Losartan potassium - 50mg 50mg Tablet 395,474 L.L
C09CA01 LOSANET G Losartan potassium - 100mg 100mg Tablet 395,474 L.L
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