Heather M Griffis1, Roger A Band2, Matthew Ruther3, Michael Harhay4, David A Asch5, John C Hershey6, Shawndra Hill6, Lindsay Nadkarni2, Austin Kilaru2, Charles C Branas7, Frances Shofer2, Graham Nichol8, Lance B Becker2, Raina M Merchant9. 1. Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Electronic address: heathermgriffis@gmail.com. 2. Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 3. Department of Geography, University of Colorado at Boulder, Boulder, CO. 4. Department of Biostatistics and Epidemiology University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 5. Penn Medicine Center for Innovation, University of Pennsylvania, Philadelphia, PA; The Wharton School, the University of Pennsylvania, Philadelphia, PA; The Philadelphia Veterans Affairs Medical Center, Philadelphia, PA. 6. The Wharton School, the University of Pennsylvania, Philadelphia, PA. 7. Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Department of Biostatistics and Epidemiology University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. 8. University of Washington-Harborview Center for Prehospital Emergency Care, Department of Medicine, University of Washington, Seattle, WA. 9. Department of Emergency Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Penn Medicine Center for Innovation, University of Pennsylvania, Philadelphia, PA. Electronic address: raina.merchant@uphs.upenn.edu.
Abstract
BACKGROUND: Survival from out-of-hospital cardiac arrest (OHCA) is generally poor and varies by geography. Variability in automated external defibrillator (AED) locations may be a contributing factor. To inform optimal placement of AEDs, we investigated AED access in a major US city relative to demographic and employment characteristics. METHODS AND RESULTS: This was a retrospective analysis of a Philadelphia AED registry (2,559 total AEDs). The 2010 US Census and the Local Employment Dynamics database by ZIP code was used. Automated external defibrillator access was calculated as the weighted areal percentage of each ZIP code covered by a 400-m radius around each AED. Of 47 ZIP codes, only 9% (4) were high-AED-service areas. In 26% (12) of ZIP codes, less than 35% of the area was covered by AED service areas. Higher-AED-access ZIP codes were more likely to have a moderately populated residential area (P = .032), higher median household income (P = .006), and higher paying jobs (P =. 008). CONCLUSIONS: The locations of AEDs vary across specific ZIP codes; select residential and employment characteristics explain some variation. Further work on evaluating OHCA locations, AED use and availability, and OHCA outcomes could inform AED placement policies. Optimizing the placement of AEDs through this work may help to increase survival.
BACKGROUND: Survival from out-of-hospital cardiac arrest (OHCA) is generally poor and varies by geography. Variability in automated external defibrillator (AED) locations may be a contributing factor. To inform optimal placement of AEDs, we investigated AED access in a major US city relative to demographic and employment characteristics. METHODS AND RESULTS: This was a retrospective analysis of a Philadelphia AED registry (2,559 total AEDs). The 2010 US Census and the Local Employment Dynamics database by ZIP code was used. Automated external defibrillator access was calculated as the weighted areal percentage of each ZIP code covered by a 400-m radius around each AED. Of 47 ZIP codes, only 9% (4) were high-AED-service areas. In 26% (12) of ZIP codes, less than 35% of the area was covered by AED service areas. Higher-AED-access ZIP codes were more likely to have a moderately populated residential area (P = .032), higher median household income (P = .006), and higher paying jobs (P =. 008). CONCLUSIONS: The locations of AEDs vary across specific ZIP codes; select residential and employment characteristics explain some variation. Further work on evaluating OHCA locations, AED use and availability, and OHCA outcomes could inform AED placement policies. Optimizing the placement of AEDs through this work may help to increase survival.
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