在英格兰公共场所部署自动化外部除器的优化
Terry P Brown1, Lazaros Andronis2, Asmaa El-Banna2
1NIHR Applied Research Collaboration West Midlands, Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
Health and social care delivery research
|March 1, 2025
概括
优化自动化外部除器 (AED) 的放置可以显著改善医院外心脏骤停的覆盖率,特别是在贫困地区. 数据驱动的模型表明基于网格的安置是最有效的,尽管社区中心提供了一个具有成本效益的替代方案.
科学领域:
- 公共卫生干预措施 公共卫生干预措施
- 医疗服务研究 医疗服务研究
- 空间分析和优化
背景情况:
- 每年发生超过32,000次医院外心脏骤停 (OHCAs),除动器对于生存至关重要.
- 目前的自动化外部除器 (AED) 位置不理想,限制了访问并影响了生存率.
- 需要确定最佳的AED放置,以提高OHCA覆盖率并改善患者的治疗结果.
研究的目的:
- 确定自动外部除器 (AED) 的最佳位置,以最大限度地覆盖非医院心脏骤停 (OHCA).
- 为了比较不同AED部署策略的有效性和成本效益.
- 解决与社会经济因素相关的AED安置差异.
主要方法:
- 对OHCA注册数据,AED位置和感兴趣点 (POI) 的二次分析.
- 计算OHCAs和AED/POI在500米以内的步行距离和覆盖范围.
- 适应最大覆盖位置问题模型以优化和开发用于成本效益分析的决策分析模型.
主要成果:
- OHCAs发生在贫困地区更多,而AED位于富裕地区,这表明存在很大的差异.
- 优化的基于网格的安置实现了78.8%的覆盖率,明显优于在POI (如现金机或学校) 的安置.
- 社区中心/大厅的安置提供了最好的成本效益 (ICER £32,418/QALY),改善了覆盖范围,而不是目前的低于最佳分布.
结论:
- 使用优化模型的数据驱动框架可以大大改善公共访问AED覆盖范围.
- 优化的安置策略比目前的或基于POI的安置更有效,尽管初始成本更高.
- 解决AED安置差异对于公平的OHCA反应和改善生存率至关重要.
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