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Are there disparities in the location of automated external defibrillators in England?

Are there disparities in the location of automated external defibrillators in England?
Are there disparities in the location of automated external defibrillators in England?
Background: Early defibrillation is an essential element of the chain of survival for out-of-hospital cardiac arrest (OHCA). Public access defibrillation (PAD) programmes aim to place automated external defibrillators (AED) in areas with high OHCA incidence, but there is sometimes a mismatch between AED density and OHCA incidence. Objectives: This study aimed to assess whether there were any disparities in the characteristics of areas that have an AED and those that do not in England. Methods: Details of the location of AEDs registered with English Ambulance Services were obtained from individual services or internet sources. Neighbourhood characteristics of lower layer super output areas (LSOA) were obtained from the Office for National Statistics. Comparisons were made between LSOAs with and without a registered AED. Results: AEDs were statistically more likely to be in LSOAs with a lower residential but higher workplace population density, with people predominantly from a white ethnic background and working in higher socio-economically classified occupations (p < 0.05). There was a significant correlation between AED coverage and the LSOA Index of Multiple Deprivation (IMD) (r = 0.79, p = 0.007), with only 27.4% in the lowest IMD decile compared to about 45% in highest. AED density varied significantly across the country from 0.82/km 2 in the north east to 2.97/km 2 in London. Conclusions: In England, AEDs were disproportionately placed in more affluent areas, with a lower residential population density. This contrasts with locations where OHCAs have previously occurred. Future PAD programmes should give preference to areas of higher deprivation and be tailored to the local community.
Automated external defibrillators, Basic life support, Health inequality, Neighbourhood characteristics, Out-of-hospital cardiac arrest, Public access defibrillation
0300-9572
28-35
Brown, Terry P.
8006bd81-0276-469d-aed4-06f5b17929f9
Perkins, Gavin D.
fd93b34c-2485-488a-8ab6-f8faf0690f73
Smith, Christopher M.
381d7dc9-3711-4705-8b32-a3f394d174fb
Deakin, Charles D.
560d993b-bbc9-4548-9990-272ed18a011d
Fothergill, Rachael
42fb438d-876d-4bd5-8110-4de8378de764
Brown, Terry P.
8006bd81-0276-469d-aed4-06f5b17929f9
Perkins, Gavin D.
fd93b34c-2485-488a-8ab6-f8faf0690f73
Smith, Christopher M.
381d7dc9-3711-4705-8b32-a3f394d174fb
Deakin, Charles D.
560d993b-bbc9-4548-9990-272ed18a011d
Fothergill, Rachael
42fb438d-876d-4bd5-8110-4de8378de764

Brown, Terry P., Perkins, Gavin D., Smith, Christopher M., Deakin, Charles D. and Fothergill, Rachael (2022) Are there disparities in the location of automated external defibrillators in England? Resuscitation, 170, 28-35. (doi:10.1016/j.resuscitation.2021.10.037).

Record type: Article

Abstract

Background: Early defibrillation is an essential element of the chain of survival for out-of-hospital cardiac arrest (OHCA). Public access defibrillation (PAD) programmes aim to place automated external defibrillators (AED) in areas with high OHCA incidence, but there is sometimes a mismatch between AED density and OHCA incidence. Objectives: This study aimed to assess whether there were any disparities in the characteristics of areas that have an AED and those that do not in England. Methods: Details of the location of AEDs registered with English Ambulance Services were obtained from individual services or internet sources. Neighbourhood characteristics of lower layer super output areas (LSOA) were obtained from the Office for National Statistics. Comparisons were made between LSOAs with and without a registered AED. Results: AEDs were statistically more likely to be in LSOAs with a lower residential but higher workplace population density, with people predominantly from a white ethnic background and working in higher socio-economically classified occupations (p < 0.05). There was a significant correlation between AED coverage and the LSOA Index of Multiple Deprivation (IMD) (r = 0.79, p = 0.007), with only 27.4% in the lowest IMD decile compared to about 45% in highest. AED density varied significantly across the country from 0.82/km 2 in the north east to 2.97/km 2 in London. Conclusions: In England, AEDs were disproportionately placed in more affluent areas, with a lower residential population density. This contrasts with locations where OHCAs have previously occurred. Future PAD programmes should give preference to areas of higher deprivation and be tailored to the local community.

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Accepted/In Press date: 24 October 2021
e-pub ahead of print date: 29 October 2021
Published date: January 2022
Additional Information: Acknowledgements We would like to thank English Ambulance services for providing details of locations of AEDs registered with them. Funding statement This analysis is part of a study “Optimisation of the Deployment of Automatic External Defibrillators in Public Places in England” funded by the National Institute for Health Research (NIHR) Health Service and Delivery Research Programme (NIHR 127368).
Keywords: Automated external defibrillators, Basic life support, Health inequality, Neighbourhood characteristics, Out-of-hospital cardiac arrest, Public access defibrillation

Identifiers

Local EPrints ID: 453762
URI: http://eprints.soton.ac.uk/id/eprint/453762
ISSN: 0300-9572
PURE UUID: 7a1b219a-5bd8-466c-b8ed-ed570cc8228f

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Date deposited: 24 Jan 2022 17:40
Last modified: 18 Oct 2022 16:58

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Contributors

Author: Terry P. Brown
Author: Gavin D. Perkins
Author: Christopher M. Smith
Author: Rachael Fothergill

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