Automated external defibrillator location and socioeconomic deprivation in Great Britain.
Heart (British Cardiac Society) 2023
PubMed ID : 37640454
The early use of automated external defibrillators (AEDs) improves outcomes in out-of-hospital cardiac arrest (OHCA). We investigated AED access across Great Britain (GB) according to socioeconomic deprivation.
Cross-sectional observational study using AED location data from The Circuit: the national defibrillator network led by the British Heart Foundation in partnership with the Association of Ambulance Chief Executives, Resuscitation Council UK and St John Ambulance. We calculated street network distances between all 1 677 466 postcodes in GB and the nearest AED and used a multilevel linear mixed regression model to investigate associations between the distances from each postcode to the nearest AED and Index of Multiple Deprivation, stratified by country and according to 24 hours 7 days a week (24/7) access.
78 425 AED locations were included. Across GB, the median distance from the centre of a postcode to an AED was 726 m (England: 739 m, Scotland: 743 m, Wales: 512 m). For 24/7 access AEDs, the median distances were further (991 m, 994 m, 570 m). In Wales, the average distance to the nearest AED and 24/7 AED was shorter for the most deprived communities. In England, the average distance to the nearest AED was also shorter in the most deprived areas. There was no association between deprivation and average distance to the nearest AED in Scotland. However, the distance to the nearest 24/7 AED was greater with increased deprivation in England and Scotland. On average, a 24/7 AED was in England and Scotland, respectively, 99.2 m and 317.1 m further away in the most deprived than least deprived communities.
In England and Scotland, there are differences in distances to the nearest 24/7 accessible AED between the most and least deprived communities. Equitable access to 'out-of-hours' accessible AEDs may improve outcomes for people with OHCA.
What is already known on this topic
· Timely use of an automated external defibrillator (AED) is associated with improved outcomes in out-of-hospital cardiac arrest.
· Access to an AED may be different depending on the deprivation of a community, which may contribute to worse survival from cardiac arrest.
What this study adds
· This study shows that the distance to the nearest AED is shorter in England and Wales for more deprived communities, with no overall trend in Scotland.
· However, when considering AEDs that are accessible 24/7, the nearest device is further in more deprived neighbourhoods in England and Scotland, and nearer in Wales.
How this study might affect research, practice, or policy
· Greater attention to equality of access to 24/7 AEDs has the potential to improve outcomes and save lives