Spatial Accessibility of Automated External Defibrillator Services in High-Density Older-Adult Areas: A Geographic Information System Analysis

초록

Purpose: We aimed to evaluate the accessibility and equity of automated external defibrillators (AEDs)in areas with a high concentration of older adults and to propose evidence-based policy directions usinggeographic information systems (GIS). Methods: For the secondary analysis, multiple datasets were integrated from the Korea's NationalGeographic Information Institute, the Ministry of the Interior and Safety, the Suwon Fire Department,and the Suwon Southern Fire Station, including continuous digital topographic maps, demographicstatistics, AED locations, road networks, and out-of-hospital cardiac arrest incidence data. The clusteringand spatial heterogeneity of AED deployment were examined using kernel density estimation andspatial autocorrelation analysis. Service areas reflecting the walking speeds of older adults weredelineated, and equity was assessed using the Gini coefficient. A two-step floating catchment areaanalysis was used to provide supply-to-demand ratios and accessibility indices. Results: AEDs exhibited clustered patterns centered on public locations, and several areas were identified as potential service blind spots, revealing inequities at the neighborhood level. Several AED siteswere insufficient for the local older-adult population, and only a subset of areas demonstrated relativelyhigh accessibility indices. Conclusion: As the population age structure shifts toward older age groups, AED policy criteria should beredesigned to reflect the mobility and accessibility of older adults. Implementing mixed relocationstrategies that incorporate age-friendly criteria, conducting periodic policy performance evaluations,and enhancing AED visibility and tailored education that accounts for the cognitive characteristics ofolder adults will contribute to improving the health of older populations.

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