Optimizing the Deployment of Public Access Defibrillators

• 成果类型: Article
• 署名作者: Chan, Timothy C. Y.; Demirtas, Derya; Kwon, Roy H.
• 署名单位: University of Toronto
• 刊物名称: MANAGEMENT SCIENCE
• ISSN/ISSBN: 0025-1909
• DOI: 10.1287/mnsc.2015.2312
• 发表日期: 2016
• 页码: 3617-3635
• 关键词: Facility location; coverage models; Kernel density estimation; automated external defibrillator; cardiac arrest

摘要

Out-of-hospital cardiac arrest is a significant public health issue, and treatment, namely, cardiopulmonary resuscitation and defibrillation, is very time sensitive. Public access defibrillation programs, which deploy automated external defibrillators (AEDs) for bystander use in an emergency, reduce the time to defibrillation and improve survival rates. In this paper, we develop models to guide the deployment of public AEDs. Our models generalize existing location models and incorporate differences in bystander behavior. We formulate three mixed integer nonlinear models and derive equivalent integer linear reformulations or easily computable bounds. We use kernel density estimation to derive a spatial probability distribution of cardiac arrests that is used for optimization and model evaluation. Using data from Toronto, Canada, we show that optimizing AED deployment outperforms the existing approach by 40% in coverage, and substantial gains can be achieved through relocating existing AEDs. Our results suggest that improvements in survival and cost-effectiveness are possible with optimization.