Can drones save lives and money? An economic evaluation of airborne delivery of automated external defibrillators

Abstract

Background Out-of-hospital cardiac arrest is one of the most frequent causes of death in Europe. Emergency medical services often struggle to reach the patient in time, particularly in rural areas. To improve outcome, early defibrillation is required which significantly increases neurologically intact survival. Consequently, many countries place Automated External Defibrillators (AED) in accessible public locations. However, these stationary devices are frequently not available out of hours or too far away in emergencies. An innovative approach to mustering AED is the use of unmanned aerial systems (UAS), which deliver the device to the scene. Methods This paper evaluates the economic implications of stationary AED versus airborne delivery using scenario-based cost analysis. As an example, we focus on the rural district of Vorpommern-Greifswald in Germany. Formulae are developed to calculate the cost of stationary and airborne AED networks. Scenarios include different catchment areas, delivery times and unit costs. Results UAS-based delivery of AEDs is more cost-efficient than maintaining traditional stationary networks. The results show that equipping cardiac arrest hot spots in the district of Vorpommern-Greifswald with airborne AEDs with a response time < 4 min is an effective method to decrease the time to the first defibrillation The district of Vorpommern-Greifswald would require 45 airborne AEDs resulting in annual costs of at least 1,451,160 €. Conclusion In rural areas, implementing an UAS-based AED system is both more effective and cost-efficient than the conventional stationary solution. When regarding urban areas and hot spots of OHCA, complementing the airborne network with stationary AEDs is advisable.

2023 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces

“…• Computer/prediction models: 17 studies used different strategies to localize optimal sites for placement of AED-drone bases and to estimate time gain compared with EMS response time. 35,[78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93] The data used varied according to geographic areas, quality and accessibility of historical OHCA data, drone type and input of diverse drone-flight details, existing EMS system, and volunteer responder programs. • Test flights/simulation studies and qualitative analysis: 9 studies of various aims, geography, and testing areas.…”

“…101 Five cost-effectiveness studies predicted the cost-effectiveness of a drone AED system to supplement existing systems to secure early defibrillation. 78,79,86,89,91 Task Force Insights A limited evidence base was identified, with most studies focused on theoretical drone base placement and estimated AED drone delivery times compared with standard EMS times. In contrast, only 1 pilot study and 1 case study reported the drone delivery of AEDs to real-world OHCAs.…”

“… 101 Five cost-effectiveness studies predicted the cost-effectiveness of a drone AED system to supplement existing systems to secure early defibrillation. 78 , 79 , 86 , 89 , 91 …”

Emergency Medicine Perspectives: The Importance of Bystanders and Their Impact on On-Site Resuscitation Measures and Immediate Outcomes of Out-of-Hospital Cardiac Arrest

“…The integration of AI-driven solutions in the form of wearable devices, for instance, could provide real-time feedback to bystanders performing CPR, or even alert nearby medical professionals or trained individuals to rush to the scene [32]. This convergence of technology and medical intervention could redefine the OHCA landscape in the coming years [33][34][35].…”

Automated external defibrillators and the link to first responder systems

“…This results in an incremental cost-effectiveness ratio (ICER) of 23 568 euros [34]. Another study from Ro ¨per et al found that equipping drones with AEDs was a more cost-effective solution compared to the conventional strategy with stationary AEDs [35]. As there is a lack of clinical data on clinical outcomes these analyses are built on somewhat heavy assumptions.…”