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To the Editor: The Research Letter by Teno and colleagues1 on persistent pain in nursing home residents used data from the Minimum Data Set (MDS), a nationally mandated nursing home resident assessment instrument, and determined that large numbers of nursing home residents lack pain relief.
In December 2000, the Inspector General (IG) of the US Department of Health and Human Services issued a report2 in which the IG determined that there were "apparently differences in nursing home staffs' understanding of the MDS and the resident assessment process.'' The IG recommended that the Health Care Financing Administration "more clearly define MDS elements" and "work with the nursing home industry to provide enhanced and coordinated training to nursing homes to be sure that similar and accurate information about the MDS is being disseminated."2 (p15)
While information taken from the MDS may be the best information available, the IG's report suggests that the document and the process are flawed.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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