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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
N03AG01 CONVULEX G Sodium valproate - 100mg/ml 100mg/ml Injectable solution 4,441,399 L.L
B03BA01 CYNOVIT-JULPHAR G Vitamin B12 - 1mg/ml 1mg/ml Injectable solution 167,980 L.L
B05XA01 CHLORURE DE POTASSIUM RENAUDIN G Potassium chloride - 7.46g/100ml 7.46% Injectable solution 385,683 L.L
J01MA02 CEFLOXINE G Ciprofloxacin - 400mg/200ml 400mg/200ml Injectable solution 1,134,203 L.L
J01MA02 CIPROFLOXACINE PANPHARMA G Ciprofloxacine (HCl) - 400mg/200ml 400mg/200ml (2mg/ml) Injectable solution 9,908,924 L.L
B03BA05 COBAL G Mecobalamine - 500mcg/ml 500mcg/ml Injectable solution 1,128,828 L.L
J01MA02 CIPROFLOXACINE PANPHARMA G Ciprofloxacine (HCl) - 400mg/200ml 400mg/200ml Injectable solution 9,908,924 L.L
B05XA01 CHLORURE DE POTASSIUM RENAUDIN G Potassium chloride - 10g/100ml 10g/100ml Injectable solution 360,150 L.L
N01BB02 CHLORHYDRATE DE LIDOCAINE RENAUDIN G Lidocaine (HCl) - 10mg/ml 1% Injectable solution 591,291 L.L
A11EA COMBEDOX G Thiamine HCl - 100mg/2ml, Pyridoxine HCl - 100mg/2ml, Cyanocobalamin - 1000mcg/2ml, Dexpanthenol - 50mg/2ml, Nicotinamide - 100mg/2ml Injectable solution 374,996 L.L
B05XA03 CHLORURE DE SODIUM 0.9 pour cent Renaudin G Sodium chloride - 0.9% 0.9% Injectable solution 385,683 L.L
B05XA03 CHLORURE DE SODIUM PROAMP G Sodium chloride - 0.9% 0.9% Injectable solution 1,104,639 L.L
A12AA03 CALCIUM GLUCONATE G Calcium gluconate - 10g/100ml 10g/100ml Injectable solution 763,056 L.L
B05XA03 CHLORURE DE SODIUM PROAMP G Sodium chloride - 0.9% 0.9% Injectable solution 705,517 L.L
A12AA03 CALCIUM GLUCONATE G Calcium gluconate - 10g/100ml 10g/100ml Injectable solution 6,867,500 L.L
A12AA03 CALCIUM GLUCONATE S.A.L.F G Calcium gluconate monohydrate - 10% 10% Injectable solution 389,714 L.L
L03AB07 CINNOVEX BioTech Interferon beta-1a - 30mcg 30mcg Injectable solution 39,804,728 L.L
N02AA01 CHLORHYDRATE DE MORPHINE RENAUDIN G Morphine HCl - 20mg/ml 20mg/ml Injectable solution 1,100,607 L.L
H01AC01 CINNATROPIN BioTech Somatropin recombinant - 5mg/1.5ml 5mg/1.5ml Injectable solution 4,699,417 L.L
H01AC01 CINNATROPIN BioTech Somatropin recombinant - 10mg/1.5ml 10mg/1.5ml Injectable solution 9,012,607 L.L
V03AF03 CALCIUMFOLINAT EBEWE G Calcium folinate - 100mg/10ml 100mg/10ml Injectable solution 1,289,872 L.L
A03FA01 CHLORHYDRATE DE METOCLOPRAMIDE RENAUDIN G Metoclopramide HCl - 10mg/2ml 10mg/2ml Injectable solution 530,818 L.L
H01BB03 CARBETOCINA GP-PHARM G Carbetocin - 100mcg 100mcg Injectable solution 9,041,227 L.L
J01XB01 COLISTIN/NORMA G Colistimethate Sodium - 1MIU 1MIU Injectable solution 872,154 L.L
B05XA07 CALCIUM CHLORIDE G Calcium chloride - 10g/100ml 10g/100ml Injectable solution 5,436,771 L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE C G Potassium chloride - 2.611g/l, Magnesium chloride, 6H2O - 5.33g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 190.505g/l, Sodium chloride - 204.54g/l Injectable solution L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE D G Potassium chloride - 5.215g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 166.7g/l, Sodium chloride - 214.76g/l Injectable solution L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE E G Potassium chloride - 2.611g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 7.00g/l, Sodium acetate, 3H2O - 190.505g/l, Sodium chloride - 205.49g/l Injectable solution L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE F G Potassium chloride - 3.914g/l, Magnesium chloride, 6H2O - 3.558g/l, Calcium chloride, 2H2O - 7.719g/l, Acetic acid 100% - 6.010ml/l, Sodium chloride - 208.631g/l Injectable solution L.L
B05ZA CONCENTRATE SOLUTION FOR HEMODIALYSIS TYPE SG G Potassium chloride - 3.92g/l, Magnesium chloride, 6H2O - 5.32g/l, Calcium chloride, 2H2O - 8.99g/l, Sodium acetate, 3H2O - 166.7g/l, Sodium chloride - 214.76g/l Injectable solution L.L
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