he time of the first consultation to the time of the final post operative check up) were col lected for each subject included in the two cluster samples. Data collected for those subjects included in the post imple mentation cluster were adjusted for both (1) cost escalations attributable to price inflation, and (2) cost reductions attri butable to the implementation of the PPS system.
The collection of data pertaining to subjects receiving Medicaid funded surgical procedures immediately prior to the implementation of the second surgical opinion requirement for Medicaid funded patients, and the collection of data pertaining to patients receiving Medicaid funded surgical procedures sub 33sequent to the implementation of the second surgical opinion requirement for Medicaid funded patients permitted and facilitated the performance of a cost comparison between the two sample groups. This cost comparison provided a basis for an evaluation of the cost effectiveness of the second surgical opinion requirement for Medicaid funded patients. Delaying the collection of post implementation data to the third six month time period subsequent to the implementation of the second sur gical opinion requirement for Medicaid funded patients allowed a one year time period for the second surgical opinion require ment to be effectively and efficiently eliminated, thereby min imizing the probability of unrepresentative data for the post implementation time period.
There was a methodologial limitation implicit in the research hypothesis, and in the research design employed in the testing of this h
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