Public-private partnerships for UAV-assisted emergency medical services in aging communities: an evolutionary game...

To analyze the current "market failure" in the large-scale deployment of UAV-assisted automated external defibrillator (AED) delivery networks for aging communities, and to explore innovative "Public-Private Partnership" (PPP) business models to overcome the "cold-start" institutional deadlock.

This study introduces a three-party evolutionary game model comprising community representatives, medical institutions, and UAV operators. By integrating principles of "health economics," we simulated the interactive decision-making processes under bounded rationality. Multi-scenario numerical simulations were employed to quantify the impact of government subsidies, revenue-sharing coefficients, and emergency order densities on the system's long-term evolutionary stability.

The simulation results reveal a significant systemic mismatch and an inherent "collective action dilemma" in the absence of policy intervention. A critical non-linear threshold was identified under our model assumptions: a minimum government subsidy ratio of 27.3% is required to effectively hedge early-stage infrastructure risks and trigger a Nash equilibrium. Furthermore, long-term stability analysis demonstrates that while initial fiscal "boosters" are essential, an endogenous emergency call density exceeding 0.12 valid calls per thousand residents monthly-a value that corresponds closely to real-world epidemiological incidences of out-of-hospital cardiac arrest (OHCA)-serves as the critical determinant for systemic sustainability within the simulated environment.

The normalized operation of UAV-assisted EMS networks is not merely an engineering optimization problem but a "socio-technical system" challenge plagued by institutional gridlock. There is an urgent need to transition from a technology-driven to an institution-driven governance paradigm. We advocate for inclusive business models based on targeted public health service procurement and the integration of UAV-assisted EMS networks into national medical reimbursement frameworks to bridge the "last-mile" emergency gap and foster "health equity" in aging populations.