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August 1991

Child Welfare: The Phantom of the Health Care System

Author Affiliations

Department of Pediatrics Jefferson Medical College Philadelphia, PA 19131

Am J Dis Child. 1991;145(8):843. doi:10.1001/archpedi.1991.02160080017001

Sir.—The problem of infants requiring prolonged hospitalization for lack of appropriate discharge placements has resulted in a new population of children receiving medical care. These children have been called "boarder babies," and their numbers are steadily increasing. On a given day in Philadelphia, Pa, 70 boarder babies are in hospitals awaiting discharge. They limit access to medical care for other children by occupying beds and increasing the hospitals' operating costs.

This is one of the most insidious side effects of the current crack cocaine epidemic, resulting in the abandonment of numerous infants in hospitals. It has resulted in what one author describes as "the youngest of the homeless."1

A June 1989 survey1 by the Child Welfare League of America of hospitals in five American cities identified 304 boarder babies in the 54 hospitals reporting cases. At least 69% of the identified babies showed signs of impairment due

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