Expectations and concerns of primary healthcare patients in rural areas and small towns in Poland regarding artificial intelligence

The integration of artificial intelligence (AI) into healthcare presents transformative opportunities, but patient perspectives, particularly from digitally excluded populations, remain underexplored. This study aimed to analyze the awareness, acceptance and concerns regarding the use of AI in healthcare among primary care patients in rural and small-town regions of Poland. This is characteristic of the country, as over 60% of its population lives in such regions. It also sought to identify the demographic and psychosocial determinants of trust in AI. A cross-sectional survey was conducted using a paper questionnaire distributed to 545 adult patients in three primary care facilities in towns with populations below 20,000. Demographics, digital literacy, and attitudes towards AI were assessed. Statistical analyses included non-parametric tests and ordinal logistic regression. Most of the respondents expressed neutrality (43%) or a negative (31%) attitudes toward AI. Only 12.7% had direct experience with AI, and full trust in AI-assisted diagnoses was low (5.9%). Education was the strongest predictor of a positive AI attitude (P < 0.001); age was also significant (P = 0.04), while gender and place of residence were not. Most patients (86%) emphasized the importance of medical staff support.Patients in areas of low digital literacy approach AI with cautious optimism, valuing its potential but requiring human oversight. To foster an equitable adoption of AI, communication and education efforts must address patient concerns and expectations.