Robert Penfold, PhD

“I do comparative effectiveness research designed to improve real-world mental health care.” 

Robert Penfold, PhD

Associate Investigator, Kaiser Permanente Washington Health Research Institute


As an economic geographer with expertise in health policy, Rob Penfold has a unique perspective on health care. By examining changes in health care use over time and in different regions of the United States, his work develops strategies to optimize health care delivery and patient outcomes. His research addresses practical issues such as how to measure direct and indirect costs of complex diseases like depression. Dr. Penfold is also especially interested in understanding how cost-control policies change the way clinicians deliver and people use care and how those changes have both positive and negative effects on health.

He is a co-investigator in the Mental Health Research Network (MHRN), a resource for studies on mental health conditions ranging from autism to postnatal depression. He leads the child and adolescent focus group within MHRN. Based at Kaiser Permanente Washington Health Research Institute as part of the Health Care Systems Research Network, the MHRN is a collaboration among nine nonprofit health care and research systems and is funded by the National Institutes of Health. Dr. Penfold also is investigating reasons why similar patients receive different mental health treatment, such as different medications, depending on where they live or receive care. With his extensive research on mental health services for children and young adults, particularly the use of antipsychotic and antidepressive drugs, he is uniquely qualified to lead these projects.

Dr. Penfold has extensive experience in gathering and analyzing information from large health databases, including those of Medicare and Medicaid, and the Health Care Systems Research Network’s Virtual Data Warehouse. These data and analyses allow rapid information sharing among Kaiser Permanente Washington and participating sites, which improves patient safety and timely access to effective, cutting-edge therapies. Researchers and clinicians at Kaiser Permanente Washington and around the world use methods developed by Dr. Penfold to study the dynamics of patient care as we implement new policies to make health care evidence-based, effective, and affordable.

Before joining KPWHRI in 2010, Dr. Penfold held research and teaching positions at Nationwide Children's Hospital in Columbus, Ohio; the Winnipeg Regional Health Authority; the Manitoba Centre for Health Policy; and most recently, at Harvard Medical School in the Department of Population Medicine and Harvard Pilgrim Health Care Institute.

Research interests and experience

  • Health Services & Economics

    Comparative  effectiveness; consumer-directed health plans; patient outcomes; costs of chronic illnesses; Medicare and Medicaid 

  • Mental Health

    Children and adolescents; anti-psychotics and anti-depressants; bipolar disorder, and depression

  • Biostatistics

    Space-time surveillance; marginal structural modeling;  interrupted time series analysis



Recent publications

Barclay RP, Penfold RB, Sullivan D, Boydston L, Wignall J, Hilt RJ. Decrease in statewide antipsychotic prescribing after implementation of child and adolescent psychiatry consultation services. Health Serv Res. 2017 Apr;52(2):561-578. doi: 10.1111/1475-6773.12539. PubMed

Wu JJ, Penfold RB, Primatesta P, Fox TK, Stewart C, Reddy SP, Egeberg A, Liu J, Simon G. The risk of depression, suicidal ideation, and suicide attempt in patients with psoriasis, psoriatic arthritis, or ankylosing spondylitis. J Eur Acad Dermatol Venereol. 2017 Feb 18. doi: 10.1111/jdv.14175. [Epub ahead of print]. PubMed

Penfold RB, Burgess JF Jr, Lee AF, Li M, Miller CJ, Nealon Seibert M, Semla TP, Mohr DC, Kazis LE, Bauer MS. Space-time cluster analysis to detect innovative clinical practices: a case study of aripiprazole in the Department of Veterans Affairs. Health Serv Res. 2016 Dec 22. doi: 10.1111/1475-6773.12639. [Epub ahead of print]. PubMed

Parchman ML, Henrikson NB, Blasi PR, Buist DS, Penfold R, Austin B, Ganos EH. Taking action on overuse: creating the culture for change. Healthc (Amst). 2016 Nov 10. pii: S2213-0764(16)30167-1. doi: 10.1016/j.hjdsi.2016.10.005. [Epub ahead of print]. PubMed


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