Project Grant R01HL185953

The National Institutes of Health National Heart, Lung, and Blood Institute awarded The Leland Stanford Junior University $737,415 on August 17, 2026, under the Cardiovascular Diseases Research program (CFDA 93.837) to examine the association between hospital market competition and inappropriate vascular surgical care in older adults.

The recipient will conduct a research study analyzing overtreatment patterns in two conditions: abdominal aortic aneurysm (AAA) repair at small sizes not supported by clinical guidelines, and tibial interventions for claudication, an early presentation of peripheral artery disease. The study will pool data from the Vascular Quality Initiative linked to Medicare and Veterans Health Administration records to examine whether market competition at a granular level correlates with higher rates of inappropriate AAA and peripheral artery disease care. The hypothesis underlying the work is that competition among surgeons combined with fee-for-service payment models creates incentives to perform vascular surgery earlier than clinically recommended, potentially causing harm through increased costs and unnecessary interventions with high re-intervention rates.

Performance will occur in Palo Alto, California, with a period of performance through May 31, 2031. This is a Project Grant, a standard assistance type under the NHLBI's competitive research program.