Zeljko Ferencic‚MD
Zeljko Ferencic‚MD

A few weeks ago, the Director-General of the World Health Organization (WHO) transmitted the Report of the fifteenth meeting of the International Health Regulations Emergency Committee, stating that COVID-19 is now an established and ongoing health issue that no longer constitutes a public health emergency of international concern. Inspired by this great news, I decided to revisit the book “Economics in One Virus” by Ryan A. Bourne (Cato Institute, Washington DC, 2021), which I borrowed from the extensive library of my friends Suzana and Dave in New Hampshire. It’s a great book, although it’s a pity it was published just before the availability of the COVID-19 vaccine. In the chapter discussing facemasks and the risk of infection, Bourne quotes the work of University of Chicago economist Sam Peltzman, published in 1975, stating that certain regulations intended to improve safety often backfire due to the behavioral changes they induce. For instance, safety improvements in car engineering, such as seat belts, airbags, and anti-lock brakes, regulated by law, can paradoxically reduce safety because people feel more secure and, therefore, take more risks on the road, nullifying the intended safety benefits.


Does the Peltzman effect present a meaningful and valid concern when it comes to the accreditation of healthcare organizations, where the reduction of medical errors plays a key role in the accreditation process? If accreditation is understood as the primary tool for maintaining patient safety, could accredited healthcare organizations be at risk of the Peltzman effect? The answer might be yes, especially if they employ a self-assessment accreditation process to evaluate their level of performance against established standards.


Two crucial questions arise:

1. Are they competent enough to accurately assess their own system? and

2. How do they survey the survey? Is it simply a matter of completing a checklist and claiming compliance, or is there more to it?


On the other hand, there are accreditation bodies like AACI that, after granting accreditation, conduct annual on-site surveys to verify compliance with the requirements for maintaining accreditation. In such cases, healthcare organizations are constantly under scrutiny regarding patient safety, which helps mitigate the Peltzman effect.