AI Implementation in U.S. Hospitals: Regional Disparities and Health Equity Implications

AI has the potential to improve healthcare delivery, but uneven geographic adoption and implementation can reinforce existing care gaps and inefficiencies. We analyzed data from 3092 U.S. hospitals using the 2023 American Hospital Association (AHA) Data, community-level socioeconomic indicators, and 2023-2025 CMS hospital quality metrics to assess: where AI is implemented, what factors drive implementation, and how AI is associated with hospital quality. We found that hospital AI implementation is significantly clustered, with over 67% misaligned with critical healthcare needs like provider shortages. Clustering- and hotspot-analysis-mapped regions with high and low AI adoption are used to identify specific areas for targeted equity interventions. Geographically weighted regression reveals that factors driving AI implementation vary by region, suggesting universal strategies may be ineffective. AI holds transformative potential for healthcare, yet adoption is geographically clustered and often misaligned with areas of greatest need. These findings underscore the urgent need for region-specific strategies to ensure AI advances health equity rather than worsening it.