Locating automated external defibrillators in urban areas: considering different travel modes.
Frontiers in Public Health · 2026-01-01 · Observational study
Abstract
INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a time-critical emergency in which rapid access to automated external defibrillators (AEDs) can improve survival. However, most AED location studies assume a single travel mode and often use population alone as a proxy for demand. This study investigates how travel-mode assumptions affect AED accessibility and optimal deployment and develops a risk-informed multimodal spatial optimization framework. METHODS: Using Wuhan, China, as a case study, an age-risk-weighted potential OHCA demand surface was constructed from 17,842 ambulance dispatch records and age-stratified population data across 1,161 1-km grid cells. The existing 3,569 AEDs were treated as fixed facilities. Accessibility was evaluated under driving, cycling, walking, Drive + Walk, and Cycling + Walk scenarios using a 4-min response threshold. Multimodal extensions of the Location Set Covering Problem (LSCP) and Maximal Covering Location Problem (MCLP) were applied to identify full-coverage requirements and priority locations. RESULTS: Baseline demand-weighted coverage varied substantially by travel mode: 85.07% for driving, 68.27% for cycling, 31.55% for walking, 53.65% for Drive + Walk, and 45.41% for Cycling + Walk. The additional AEDs required for universal coverage ranged from 68 under driving to 521 under walking, with 327 required under Drive + Walk. Under the first-phase MCLP strategy, 65 new AEDs increased Drive + Walk demand-weighted coverage to 73.31%. Sensitivity analysis confirmed that the main findings were robust to alternative mode weights. DISCUSSION: AED accessibility and optimal deployment are highly sensitive to responder mobility assumptions. Incorporating heterogeneous travel modes and age-specific OHCA risk can support more realistic, spatially targeted, and resource-efficient AED planning.
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Tags
Automated external defibrillator · Time intervals · Urban
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