Lee Dokyeong, Stiepak Jan-Karl, Pommerenke Christopher, Poloczek Stefan, Grittner Ulrike, Prugger Christof
Institute of Public Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Fire department of Berlin, Berlin; Emergency Medical Services Medical Director, Berlin; Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin; Berlin Institute of Health, Charité - Universitätsmedizin Berlin.
Dtsch Arztebl Int. 2022 Jun 7;119(22):393-399. doi: 10.3238/arztebl.m2022.0180.
The use of a public access defibrillator (PAD) increases the probability of surviving an out-of-hospital cardiac arrest (OHCA). No strategies exist, however, for the optimal distribution of PADs in an urban area in order to meet existing needs and ensure equal access for all potential users. It thus seems likely that the accessibility of PADs on the spatial level varies widely as a function of living circumstances.
This cross-sectional study is based on registry data concerning PAD (2022, n = 776) and OHCA (2018-2020, n = 4051), along with data on socioeconomic factors on the spatial level in Berlin (12 districts and 137 subdistricts). Associations of socioeconomic factors with the number of PADs per 10 000 inhabitants and the PAD coverage rate of sites of previous OHCAs were investigated.
The median number of PADs per 10 000 inhabitants ranged from 0.46 to 2.67 at the district level, and only five districts had a median PAD coverage rate of sites of previous OHCAs above 0%, after aggregation of the analyses at the subdistrict level. Subdistricts with a more favorable economic status and a greater income disparity had a higher PAD density. Socially disadvantaged subdistricts had no association with PAD density.
There are large deficits in the distribution of PADs at the small-scale spatial level in Berlin with respect to the goals of meeting existing needs and ensuring equal access for all potential users. The findings presented here will be of importance for the planning of future PAD programs so that the distributional efficiency and fairness of PAD in urban areas can be improved.
使用公共自动体外除颤器（PAD）可提高院外心脏骤停（OHCA）患者的存活概率。然而，目前尚无策略可用于在城市地区优化PAD的分布，以满足现有需求并确保所有潜在使用者都能平等使用。因此，PAD在空间层面的可及性似乎会因生活环境的不同而有很大差异。
这项横断面研究基于有关PAD（2022年，n = 776）和OHCA（2018 - 2020年，n = 4051）的登记数据，以及柏林空间层面的社会经济因素数据（12个区和137个分区）。研究了社会经济因素与每10000名居民的PAD数量以及既往OHCA发生地点的PAD覆盖率之间的关联。
在区一级，每10000名居民的PAD中位数数量在0.46至2.67之间，在分区层面汇总分析后，只有五个区既往OHCA发生地点的PAD中位数覆盖率高于0%。经济状况较好且收入差距较大的分区PAD密度较高。社会弱势分区与PAD密度无关联。
在柏林小规模空间层面，PAD的分布在满足现有需求和确保所有潜在使用者平等使用方面存在很大不足。此处呈现的研究结果对于未来PAD项目的规划具有重要意义，以便提高城市地区PAD的分布效率和公平性。
