Big-city hospitals find themselves baby-sitting for children whose parents can't or won't take them home. In some North Carolina communities, the problem involves babies with medical conditions too complicated for their families to handle.
Last spring the National Association of Public Hospitals and the Child Welfare League of America surveyed 72 hospitals in large American cities and found that many of them are doing a lot of baby-sitting.
The survey showed these hospitals often keep ``boarder babies' primarily because their parents cannot care for them at home. New York City hospitals reported 358 such babies during the one month when thesurvey was taken.Sometimes the reason is substance abuse; most of the children involved had some prenatal exposure to drugs or alcohol.
In many North Carolina communities, ``boarder babies' are not so numerous. However, whatever the cause of their condition, it often requires around-the-clock care. Many families cannot provide such care.
Even if they could, many insurance policies do not cover attendant care for three daily shifts. Often the parents can't attend to the child themselves for 24 hours a day; nor can they pay someone else to do it.
In extreme cases, the children end up in foster homes. But it's difficult for social workers to find foster parents at all, let alone those who are willing and able to care for very sick children. Some hospitals, such as Hahnemann University Hospital in Philadelphia, have to recruit their own employees to act as foster parents.
These cases may be infrequent - say, half a dozen children a year in Greensboro - but they are a heavy strain on medical and social services systems. At East Carolina University School of Medicine they report that at any one time they may have two or three babies who stay in their neonatal intensive care unit for six to nine months after birth, simply because they cannot be cared for at home. They are costly in terms of medical care as well as labor.
ECU doctors have helped launch a new center for such children - some who are dependent on ventilators to breathe, and others who need less intense care. When the Howell Center opens in the fall, it will be just a few miles from Greenville but it will serve children from across the state.
Some North Carolina physicians believe the plights of at least some of these children could be relieved if insurance covered 24-hour-a-day care, thus relieving weary or untrained parents and allowing them to earn a living.
The idea is a sound one. For families who are able to handle it, home care could help cut the considerable costs for these families and their insurance providers as well.
Although more support is obviously in order for some families, underwriting in-home care for their babies is a healthy start.