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A Telehealth Model in Prison Units of Sao Paulo State: Implementation and Preliminary Results
ABSTRACT
Background:
Brazil’s prison population faces severe health inequities, with high rates of chronic, infectious, and mental health conditions. TeleSAP, a telehealth model, was launched to expand primary healthcare access through teleconsultations in prison units (PU) of Sao Paulo State.
Objective:
To describe the implementation process of the TeleSAP model in PU across Sao Paulo State, Brazil.
Methods:
This descriptive observational study was conducted using telehealth data from 68 prison units between June 2024 and June 2025. Teleconsultations were delivered by family and community physicians via a secure institutional platform. Operational metrics, clinical data, and satisfaction scores (Net Promoter Score - NPS) were analyzed. Additionally, a training program was provided for prison healthcare teams.
Results:
A total of 21,413 teleconsultations were conducted for 16,062 patients, achieving a 98.7% occupancy rate, an 87.5% effectiveness rate, and high patient satisfaction (NPS = 96). The most frequent clinical conditions were psychological (21.8%), dermatological (12.8%), and respiratory (12.3%). The training program reached 732 professionals across 34 topics, also receiving high satisfaction ratings (NPS = 89).
Conclusions:
The TeleSAP model is a viable and scalable approach for integrating telehealth into prison healthcare, expanding access to care in Sao Paulo’s prison units and supporting staff development. These findings highlight the importance of structured training, metric monitoring, and stakeholder engagement for sustainable implementation. Future research should evaluate long-term outcomes, cost-effectiveness, and broader population health impacts. Clinical Trial: N/A
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