Public perceptions of AI-driven decision-making in healthcare: A structural equation modeling approach

Abstract:Artificial intelligence (AI) is increasingly integrated into healthcare to support diagnostics, decision-making, and administrative processes. However, the successful implementation of AI depends not only on technical performance but also on public perceptions of its helpfulness, riskiness, and fairness. This study examines public perceptions of automated decision-making (ADM) in healthcare. Data were drawn from the first wave of an ongoing longitudinal survey panel. The final sample consisted of 3,915 respondents and was analyzed with structural equation modeling. Perceptions of ADM in healthcare as helpful, risky, and fair were treated as the dependent variables. AI literacy, familiarity with different forms of AI, confidence in clinicians' ability to distinguish AI- from human-generated content, use of conversational agents for health information, and use of traditional digital health information sources were included as exogenous. Greater familiarity with different forms of AI, higher confidence in the clinician's ability to recognize AI-generated content, and use of conversational agents for health information were associated with greater perceived helpfulness. Use of conversational agents was associated with lower perceived risk, whereas greater familiarity with AI and greater reliance on traditional health information sources were associated with higher perceived risk. Perceptions of ADM as fair were most strongly predicted by confidence in the clinician's ability, with additional small positive associations with AI familiarity, AI literacy, and use of conversational agents. Public perceptions of ADM in healthcare are shaped by technological familiarity, use of conversational agents, and confidence in human oversight. Overall, ADM's perceived helpfulness and fairness are driven more by trust in healthcare professionals than by trust in the technology itself.

Human-Computer Interaction (cs.HC); Artificial Intelligence (cs.AI)

arXiv:2607.18884 [cs.HC]

(or arXiv:2607.18884v1 [cs.HC] for this version)

https://doi.org/10.48550/arXiv.2607.18884 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website.

Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them.

Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs.