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0034/2026 - Digital Infrastructure as a Determinant of Telehealth in São Paulo’s SUS: An Analysis of Digital Health Maturity.
Infoestrutura como fator determinante da Telessaúde no SUS em São Paulo: uma análise da maturidade digital em saúde.

Author:

• João Alves Gonçalves Neto - Gonçalves Neto, JA - <j212391@dac.unicamp.br>
ORCID: https://orcid.org/0009-0001-4262-0211

Co-author(s):

• Alexandre Lippelt Ribeiro dos Santos - Santos, ALR - <a151929@dac.unicamp.br, alexandre.lippelt@gmail.com>
ORCID: https://orcid.org/0009-0006-2737-3538
• Amanda Fernandes Delgado - Delgado, AF - <fernandespericias@gmail.com>
ORCID: https://orcid.org/0009-0007-5357-3995
• Silvia Amélia Scudeller Vedovello - Vedovello, SAS - <sasv@unicamp.br>
ORCID: https://orcid.org/0000-0002-7203-2867
• Marcelo de Castro Meneghim - Meneghim, MC - <meneghim@unicamp.br>
ORCID: https://orcid.org/0000-0003-2673-3627


Abstract:

This study investigated the association between the domains of the National Digital Health Maturity Index (INMSD) and the Telehealth and Digital Services score across administrative health regions of the SUS in São Paulo. The analysis covered the state’s 18 Health Macroregions (RRAS), using descriptive statistics, Pearson correlation, and linear regression with a 5% significance level. The overall INMSD mean was 0.40, with high variability (0.32–0.86) among macroregions. The domains “Professional Training and Development” and “Telehealth and Digital Services” showed the lowest means and greatest variability. Strong positive correlations were initially observed between telehealth and several domains. However, after identifying influential and discrepant macroregions, the regression models were readjusted with their exclusion to improve robustness. After adjustment, only the “Digital Infrastructure” domain remained a significant predictor of the “Telehealth and Digital Services” score (r=0.61; p=0.0091) in the final model. Digital infrastructure thus emerges as the main determinant for advancing telehealth in São Paulo’s SUS, indicating that investments in this area are essential to strengthen digital health and reduce regional disparities.

Keywords:

Digital Health; Telehealth; Unified Health System; Information Technology; Brazil.

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Gonçalves Neto, JA, Santos, ALR, Delgado, AF, Vedovello, SAS, Meneghim, MC. Digital Infrastructure as a Determinant of Telehealth in São Paulo’s SUS: An Analysis of Digital Health Maturity.. Cien Saude Colet [periódico na internet] (2026/Jan). [Citado em 15/08/2026]. Está disponível em: http://www.cienciaesaudecoletiva.com.br/en/articles/digital-infrastructure-as-a-determinant-of-telehealth-in-sao-paulos-sus-an-analysis-of-digital-health-maturity/19932?id=19932&id=19932



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