Observed Equity and Driving Factors of Automated External Defibrillators: A Case Study Using WeChat Applet Data

Abstract

Out-of-hospital cardiac arrest (OHCA) causes a high mortality rate each year, which is a threat to human well-being and health. An automated external defibrillator (AED) is an effective device for heart attack-related diseases and is a panacea to save OHCA. Most relevant literature focuses on the spatial distribution, accessibility, and configuration optimization of AED devices, which all belong to the characteristics of the spatial distribution of AED devices. Still, there is a lack of discussion on related potential influencing factors. In addition, analysis of AED facilities involving multiple city comparisons is less considered. In this study, data on AED facilities in two major cities in China were obtained through the WeChat applet. Then, the AED equity at the city and block scales and its socioeconomic factors were analyzed using the Gini coefficient, Lorenz curve, and optimal parameters-based geo-graphical detector (OPGD) model. Results show that the number of AEDs in Shenzhen was about eight-times that of in Guangzhou. The distribution of AEDs in Shenzhen was more equitable with a global Gini of 0.347, higher than that in Guangzhou with a global Gini of 0.504. As for the determinants of AED equity, residential density was the most significant determinant in both Guangzhou and Shenzhen from the perspective of individual effects on AED equity. Differently, due to the aging population in Guangzhou, the proportion of the elderly in blocks was influential to local AED equity. The local economic development level was crucial to local AED equity in Shenzhen. The results of the interaction detector model illustrate that relatively equitable AED distributions were found in the high-density residential areas with a balance of employment and housing, high-aging residential areas, and high-mobility residential areas in Guangzhou. The area with a high level of local economic development, dense population, and large mobility was the area with a relatively equitable distribution of AEDs in Shenzhen. The results of this paper are conducive to understanding the equity of AEDs and its socio-economic determinants, providing scientific reference for the optimization and management of AEDs.