Mrs Maria Cristina Peñaloza Ramos MA, PG Cert, BSc

Mrs Maria Cristina Peñaloza Ramos

Institute of Applied Health Research
Research Fellow

Contact details

Health Economics
Institute of Applied Health Research
College of Medical and Dental Sciences
University of Birmingham
B15 2TT

Cristina Penaloza is a Research Fellow in the Health Economics Unit. 

Cristina has published research papers in various journals in the fields of economic evaluation of interventions for the prevention of cardiovascular disease, measurement of healthcare productivity, efficiency, equity, coverage, utilization of healthcare services, evaluation of autonomization of hospitals and decentralization of health systems.


  • Doctoral Researcher
  • PG Cert in Academic Practice
  • Research Fellow of the Higher Education Academy
  • MA in Economic Development
  • Specialist in Social Projects Appraisal
  • BSc in Economics


Cristina Penaloza, BSc in Economics, Specialist in Social Projects Appraisal and MA in Economic Development. In 2014 Cristina completed a PG Certificate in Academic Practice at the University of Birmingham, where she is currently undertaking PhD studies in Health Economics.

Since 1997 Cristina has been extensively working in health economics in the UK and at international level. Cristina has broad experience as independent consultant, civil servant, and researcher. She has worked in Colombia, Chile and the UK, as health economist undertaking different roles, such as project director, health specialist, health economist, and researcher in projects financed by local governments, UNDP, United Nations Economic Commission for Latin America and the Caribbean, and the World Bank.

During 2007 and 2010 she was a Senior Research Officer in the Office for National Statistics, where she was the health specialist measuring outputs, inputs and productivity of NHS. During that time, Cristina had direct involvement in six peer reviewed non-journal productivity articles, of which she was the lead author of three of the articles. In August 2010, Cristina joined the Health Economics Unit at the University of Birmingham, where she is working in economic evaluation, and modelling of cardiovascular diseases.

The majority of Cristina’s published work in recent years has been in the area of measurement of productivity of health services and economic evaluation alongside interventions for the prevention of cardiovascular disease, working alongside colleagues in Primary Care Clinical Sciences in the University of Birmingham, Department of Primary Care Health Sciences, University of Oxford and Primary Care Unit, University of Cambridge.

When Cristina first joined the Health Economics Unit, she worked on an NIHR-funded Stroke Prevention programme grant and Theme 7 (Optimisation of the Management of Stroke and Transient Ischaemic Attack) of the Birmingham and Black Country CLAHRC, ’the Cost-effectiveness of optimising acute stroke care services for thrombolysis’ which aimed to establish the cost-effectiveness of increasing thrombolysis rates through a series of hypothetical ‘change strategies’ designed to optimise the acute care pathway for stroke. Her expertise in this area has led to further collaboration on cardiovascular projects, and she is currently involved in various other studies; the cost-effectiveness analysis of self-management of blood pressure in stroke and at risk groups (TASMIN-SR), the stroke-oxygen study (SOS2), a randomisation controlled trial of different blood pressure targets for people with a history of stroke or transient ischaemic attack (TIA) in primary care.

More recently she has been a co-applicant on a number of research grants, including three NIHR programme grants in the areas of Atrial Fibrillation (CBT-AF), Reinforcement of closure of stoma site randomised controlled trial (ROCSS), where she leads the health economics work streams and the Metoclopramide and selective oral decontamination for Avoiding Pneumonia after Stroke (MAPS-2) Trial: a 2x2 double-blind, randomized controlled trial of metoclopramide and selective oral decontamination for the prevention of pneumonia in patients with dysphagia after an acute stroke.

As part of her doctoral research work, Value In Health accepted for publication the results of a systematic review of guidelines in decision analytic modelling and practical framework to assess adherence to decision analytic modelling.


Health Economics and Health Policy MSc/Postgraduate Diplomaand Public Health MPH/PG Diploma/PG Certificate:

  • Statistics (Module coordinator and lecturer)
  • IHE
  • HEHP

Department of Economics

  • Health economics course on CBA and Shadow pricing

Postgraduate supervision

Since Cristina first joined the HEU in 2010, she has supervised more than 10 Master students in areas such as the measurement of health care productivity, evaluation of health technologies or programmes (as an example, Stay well), the systematic review of health care related programmes such as vaccination in low and middle income countries, the assessment of time and travel costs by patients among others.



Cardiovascular Research, Clinical Trials, Evidence Based Health Care, Health Services Research 


Economic evaluation and cost-effectiveness analysis using Decision Trees, Markov models, Discrete Event Simulation models

Use of decision modelling in economic evaluations

Economic evaluation of the management of chronic disease.

Economic evaluation for cardiovascular disease interventions, with a focus on primary and secondary stroke prevention and management of acute stroke.


MC Penaloza, P Barton, S Jowett, A Sutton. A systematic review of research guidelines in Decision Analytic Modelling Value in Health (In press, Value in Health)

Richard J. McManus, FRCGP; Jonathan Mant, MD; M. Sayeed Haque, PhD; Emma P. Bray, PhD; Stirling Bryan, PhD; Sheila M. Greenfield, PhD; Miren I. Jones, PhD; Sue Jowett, PhD; Paul Little, MD; Cristina Penaloza, MA; Claire Schwartz, PhD; Helen Shackleford, RGN; Claire Shovelton, PhD; Jinu Varghese, RGN; Bryan Williams, MD; F.D. Richard Hobbs, FMedSci.  Effect of Self-monitoring and Medication Self-titration on Systolic Blood Pressure in Hypertensive Patients at High Risk of Cardiovascular DiseaseThe TASMIN-SR Randomized Clinical Trial. JAMA. 2014;312(8):799-808. doi:10.1001/jama.2014.10057.

MC Penaloza, JP Sheppard, S Jowett, P Barton, J Mant, T Quinn, RM Mellor, D Sims, D Sandler, RJ McManus. Cost-effectiveness of optimising acute stroke care services for thrombolysis in UK hospitals. Stroke. 2014;45:553-562; originally published online January 2, 2014

C O’Brien, E.P Bray, S Bryan, S.M Greenfield, M Sayeed Haque, FD Richard Hobbs, M.I Jones, S Jowett, B Kaambwa, P Little, J Mant, MC Penaloza, C Schwartz, H Shackleford, J Varghese, B Williams and RJ McManus. “Targets and self-management for the control of blood pressure in stroke and at risk groups (TASMIN-SR): protocol for a randomised controlled trial” BMC Cardiovascular Disorders. 2013, 13:21.

Penaloza, C, “Healthcare Productivity”, Economic & Labour Market Review, Office for National Statistics, Vol 4, No 6, pages 63-67, June 2010

Penaloza et al. “Public Service Output, Input and Productivity: Healthcare”. Public Sector Services,  Office for National Statistics. March 2010. Available at:

Penaloza, M. “Public Service Output, Input and Productivity: Healthcare Triangulation”. Public Sector Services, Office for National Statistics. March 2010. Available at:

Hardie, M. Penaloza, “M. Public Service Output, Input and Productivity: Healthcare - Extended Analysis”. Public Sector Services, Office for National Statistics. March 2010. Available at: