{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T02:32:02Z","timestamp":1786415522352,"version":"build-2736575974"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012155","name":"National Institute for Medical Research Development","doi-asserted-by":"publisher","award":["NIMAD.REC.1397.290"],"award-info":[{"award-number":["NIMAD.REC.1397.290"]}],"id":[{"id":"10.13039\/501100012155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cataract surgery is among the most frequently performed procedures globally and in Iran, often regarded as highly effective and cost-efficient. However, its rapid growth, particularly under a fee-for-service model, raises concerns about supplier-induced demand, where providers may influence patients to undergo potentially discretionary procedures to maintain income. We analyzed administrative data from the Iranian Armed Forces Insurance Organization, covering active and retired military personnel and their families across all 31 provinces. In total, 108 055 cataract surgeries performed by 644 ophthalmic surgeons during the study period were included. As service provision and coverage for armed forces beneficiaries may differ from the general population, through dedicated military hospitals or subsidized services in public hospitals, the findings primarily reflect utilization patterns within this insured population. We employed regression-based methods to examine the relationship between surgeon density and surgery rates. A 10% increase in ophthalmologist density is associated with a 4.9%\u20136.2% increase in surgery count, 7.3%\u20137.9% in service volume, and 1.5%\u20131.9% in service value, indicating both quantitative and qualitative dimensions of inducement. Lagged service variables demonstrated significant persistence, reflecting clinical inertia. Income became a significant determinant only in the dynamic model, highlighting the role of latent demand-side factors. Our findings provide evidence consistent with supply-sensitive utilization patterns predicted by SID theory in Iran's cataract surgery sector. These insights underscore the need for targeted policy interventions, including payment reform, utilization oversight, and equitable workforce distribution, to align provider behavior with clinical necessity and system efficiency.<\/jats:p>","DOI":"10.1093\/heapol\/czag026","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T12:43:55Z","timestamp":1774701835000},"page":"877-886","source":"Crossref","is-referenced-by-count":0,"title":["Examining supplier-induced demand under regulated fees: dynamic panel evidence from Iran"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5387-3134","authenticated-orcid":false,"given":"Cyrus","family":"Alinia","sequence":"first","affiliation":[{"name":"Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences , Urmia ,","place":["Iran"]},{"name":"Damari Community Ophthalmology Research Center , Tehran ,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9919-0235","authenticated-orcid":false,"given":"Hasan","family":"Yusefzadeh","sequence":"additional","affiliation":[{"name":"Department of Health Management and Economics, School of Public Health, Urmia University of Medical Sciences , Urmia ,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"2026081022165837800_czag026-B1","doi-asserted-by":"publisher","first-page":"469","DOI":"10.26719\/2018.24.5.469","article-title":"Population and mortality profile in the Islamic Republic of Iran, 2006\u20132035","volume":"24","author":"Aghamohamadi","year":"2018","journal-title":"East Mediterr Health J"},{"key":"2026081022165837800_czag026-B2","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1002\/hpm.3360","article-title":"Unnecessary ultrasonography as supplier-induced demand in diagnosis of primary breast cancer in Iran: a cross-sectional study","volume":"37","author":"Akbari","year":"2022","journal-title":"Int J Health Plann Manage"},{"key":"2026081022165837800_czag026-B3","doi-asserted-by":"publisher","first-page":"651","DOI":"10.2147\/CEOR.S219802","article-title":"Moving toward universal health coverage: four decades of experience from the Iranian health system","volume":"11","author":"Alinia","year":"2019","journal-title":"Clinicoecon Outcomes Res"},{"key":"2026081022165837800_czag026-B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-021-06697-6","article-title":"Physician induced demand for knee replacement surgery in Iran","volume":"21","author":"Alinia","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"2026081022165837800_czag026-B5","doi-asserted-by":"publisher","first-page":"E888","DOI":"10.1016\/S2214-109X(17)30293-0","article-title":"Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis","volume":"5","author":"Bourne","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2026081022165837800_czag026-B6","doi-asserted-by":"publisher","first-page":"E489","DOI":"10.1016\/S2214-109X(20)30488-5","article-title":"The lancet global health commission on global eye health: vision beyond 2020","volume":"9","author":"Burton","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2026081022165837800_czag026-B7","doi-asserted-by":"publisher","first-page":"1024337","DOI":"10.3389\/fpubh.2023.1024337","article-title":"How does market competition affect supplier-induced demand? An experimental study","volume":"11","author":"Chen","year":"2023","journal-title":"Front Public Health"},{"key":"2026081022165837800_czag026-B8","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1002\/hec.823","article-title":"Fixed fees and physician-induced demand: a panel data study on French physicians","volume":"12","author":"Delattre","year":"2003","journal-title":"Health Econ"},{"key":"2026081022165837800_czag026-B9","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1007\/s10657-025-09836-0","article-title":"Supply-induced demand: insights from tax litigation","volume":"59","author":"Esposito","year":"2025","journal-title":"Eur J Law Econ"},{"key":"2026081022165837800_czag026-B10","volume-title":"Supplier-Induced Demand: Some Empirical Evidence and Implications","author":"Evans","year":"1974"},{"key":"2026081022165837800_czag026-B11","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1353\/pbm.2003.0004","article-title":"Health care quality, geographic variations, and the challenge of supply-sensitive care","volume":"46","author":"Fisher","year":"2003","journal-title":"Perspect Biol Med"},{"key":"2026081022165837800_czag026-B12","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/S0167-6296(00)00087-4","article-title":"Type of contract and supplier-induced demand for primary physicians in Norway","volume":"20","author":"Grytten","year":"2001","journal-title":"J Health Econ"},{"key":"2026081022165837800_czag026-B13","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1097\/ICU.0000000000001092","article-title":"Global prevalence of cataract surgery","volume":"36","author":"Hashemi","year":"2025","journal-title":"Curr Opin Ophthalmol"},{"key":"2026081022165837800_czag026-B14","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1097\/OPX.0000000000000590","article-title":"Distribution of cataract surgical rate and its economic inequality in Iran","volume":"92","author":"Hashemi","year":"2015","journal-title":"Optom Vis Sci"},{"key":"2026081022165837800_czag026-B15","first-page":"961","article-title":"Trend in cataract surgical rate in Iran provinces","volume":"43","author":"Hashemi","year":"2014","journal-title":"Iran J Public Health"},{"key":"2026081022165837800_czag026-B16","doi-asserted-by":"publisher","first-page":"878","DOI":"10.1136\/bjophthalmol-2018-311946","article-title":"Prevalence and causes of vision loss in South-East Asia and Oceania in 2015: magnitude, temporal trends and projections","volume":"103","author":"Keeffe","year":"2019","journal-title":"Br J Ophthalmol"},{"key":"2026081022165837800_czag026-B17","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s12939-025-02440-3","article-title":"Hospitalization and cost trends during Iranian health system reforms over two decades: a time series analysis","volume":"24","author":"Khadivi","year":"2025","journal-title":"Int J Equity Health"},{"key":"2026081022165837800_czag026-B18","doi-asserted-by":"publisher","first-page":"1361","DOI":"10.1186\/s12913-025-13167-w","article-title":"Challenges for health workforce in the Iranian healthcare system: a scoping review","volume":"25","author":"Khodayari-Zarnaq","year":"2025","journal-title":"BMC Health Serv Res"},{"key":"2026081022165837800_czag026-B19","doi-asserted-by":"publisher","first-page":"561","DOI":"10.2147\/OPTH.S170277","article-title":"Quality of life after refractive surgery: ReLEx SMILE vs Femto-LASIK","volume":"13","author":"Klokova","year":"2019","journal-title":"Clin Ophthalmol (Auckland, Nz)"},{"key":"2026081022165837800_czag026-B20","doi-asserted-by":"publisher","first-page":"607","DOI":"10.2147\/RMHP.S366759","article-title":"Achieving universal health coverage in low- and middle-income countries: challenges for policy post-pandemic and beyond","volume":"16","author":"Kodali","year":"2023","journal-title":"Risk Manag Healthc Policy"},{"key":"2026081022165837800_czag026-B21","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1016\/S0140-6736(17)30544-5","article-title":"Cataracts","volume":"390","author":"Liu","year":"2017","journal-title":"Lancet"},{"key":"2026081022165837800_czag026-B22","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1016\/j.jcrs.2012.03.006","article-title":"Evidence-based guidelines for cataract surgery: guidelines based on data in The European Registry of Quality Outcomes for Cataract and Refractive Surgery Database","volume":"38","author":"Lundstr\u00f6m","year":"2012","journal-title":"J Cataract Refract Surg"},{"key":"2026081022165837800_czag026-B23","doi-asserted-by":"publisher","first-page":"1553","DOI":"10.1016\/S0886-3350(01)00984-1","article-title":"Quality of life after first-and second-eye cataract surgery: five-year data collected by The Swedish National Cataract Register","volume":"27","author":"Lundstr\u00f6m","year":"2001","journal-title":"J Cataract Refract Surg"},{"key":"2026081022165837800_czag026-B24","first-page":"461","volume-title":"Handbook of Health Economics","author":"Mcguire","year":"2000"},{"key":"2026081022165837800_czag026-B25","author":"Mocking"},{"key":"2026081022165837800_czag026-B26","first-page":"1","article-title":"The elderly population in Iran: an ever growing concern in the health system","volume":"6","author":"Noroozian","year":"2012","journal-title":"Iran J Psychiatry Behav Sci"},{"key":"2026081022165837800_czag026-B27","doi-asserted-by":"crossref","DOI":"10.1787\/9789264233386-en","volume-title":"Fiscal Sustainability of Health Systems Bridging Health and Finance Perspectives: Bridging Health and Finance Perspectives","author":"OECD","year":"2015"},{"key":"2026081022165837800_czag026-B28","doi-asserted-by":"publisher","first-page":"1062","DOI":"10.1016\/j.healthpol.2022.07.011","article-title":"Induced demand in kidney replacement therapy","volume":"126","author":"Redeker","year":"2022","journal-title":"Health Policy"},{"key":"2026081022165837800_czag026-B29","doi-asserted-by":"publisher","first-page":"951","DOI":"10.1007\/s10198-023-01638-y","article-title":"New evidence on supplier-induced demand in China's public tertiary hospitals: is the cost of hospitalization higher in the off-season?","volume":"25","author":"Shen","year":"2024","journal-title":"Eur J Health Econ"},{"key":"2026081022165837800_czag026-B30","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/j.jhealeco.2014.03.003","article-title":"Supplier-induced demand for newborn treatment: evidence from Japan","volume":"35","author":"Shigeoka","year":"2014","journal-title":"J Health Econ"},{"key":"2026081022165837800_czag026-B31","first-page":"45","volume-title":"Handbook of Health Economics","author":"Skinner","year":"2011"},{"key":"2026081022165837800_czag026-B32","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1186\/s12913-021-06620-z","article-title":"A scoping review of public hospitals autonomy in Iran: from budgetary hospitals to corporate hospitals","volume":"21","author":"Sohrabi","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"2026081022165837800_czag026-B33","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1377\/hlthaff.25.1.119","article-title":"Do physician-owned cardiac hospitals increase utilization?","volume":"25","author":"Stensland","year":"2006","journal-title":"Health Aff (Millwood)"},{"key":"2026081022165837800_czag026-B34","doi-asserted-by":"publisher","first-page":"19","DOI":"10.5633\/amm.2018.0103","article-title":"Visual function and quality of life in pseudophakic patients","volume":"57","author":"Vuk\u0161a","year":"2018","journal-title":"Acta Med Medianae"},{"key":"2026081022165837800_czag026-B35","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1002\/hpm.836","article-title":"Physician supply, supplier-induced demand and competition: empirical evidence from a single-payer system","volume":"21","author":"Xirasagar","year":"2006","journal-title":"Int J Health Plan Manage"},{"key":"2026081022165837800_czag026-B36","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1111\/ceo.13430","article-title":"Longitudinal changes in global cataract surgery rate inequality and associations with socioeconomic indices","volume":"47","author":"Yan","year":"2019","journal-title":"Clin Exp Ophthalmol"},{"key":"2026081022165837800_czag026-B37","doi-asserted-by":"publisher","first-page":"580","DOI":"10.34172\/aim.31106","article-title":"The gap between the actual cost and tariffs of global surgical procedures: a retrospective cross-sectional study in Qazvin province, Iran","volume":"27","author":"Zarei","year":"2024","journal-title":"Arch Iran Med"}],"container-title":["Health Policy and Planning"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/heapol\/advance-article-pdf\/doi\/10.1093\/heapol\/czag026\/67696048\/czag026.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapol\/article-pdf\/41\/5\/877\/67696048\/czag026.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/heapol\/article-pdf\/41\/5\/877\/67696048\/czag026.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T02:17:03Z","timestamp":1786414623000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/heapol\/article\/41\/5\/877\/8566482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":37,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3,31]]},"published-print":{"date-parts":[[2026,5,20]]}},"URL":"https:\/\/doi.org\/10.1093\/heapol\/czag026","relation":{},"ISSN":["0268-1080","1460-2237"],"issn-type":[{"value":"0268-1080","type":"print"},{"value":"1460-2237","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5]]},"published":{"date-parts":[[2026,3,31]]}}}