無人機AED配送基地之資料驅動選址最佳化： 以縮短院外心臟驟停患者反應時間為目標

Abstract

院外心臟驟停（OHCA）為全球死因之一，存活率隨自動體外去顫器（AED）反應時間的增加而顯著下降。現有緊急醫療服務（EMS）雖提供一定水準的覆蓋率，距離 EMS 站點較遠的患者仍需要較長的反應時間。因此，本研究將目標族群定義為距離EMS站點較遠的OHCA（EMS-remote OHCA），並探討使用無人機協助運送AED能否有效縮短反應時間。研究透過建立兩種目標函數的最佳化模型：最小化歷史EMS反應時間，以及最小化基於路網距離之最近站點EMS反應時間，以決定無人機基地配置，並藉由分析柏拉圖最佳解與重複隨機切分驗證之模擬框架，評估無人機服務案例與整合系統的表現。 研究使用台灣台北市與新北市2022至2023年之真實OHCA與派遣資料進行分析，並以現有EMS站點作為無人機潛在基地候選。根據研究結果，無人機在現實派遣條件下能有效縮短EMS-remote OHCA案例的反應時間，此效益在不同無人機數量下維持穩定，且僅需數台無人機便能服務相當數量之案例，顯示合適的基地選址對系統效能的影響較無人機數量的擴充更為關鍵。此外，歷史派遣導向之配置可服務較多案例，最近站點導向之配置則優先改善反應時間最長的患者，反映出覆蓋廣度與延誤改善深度之間的取捨。本研究建議近期優先採用歷史派遣導向之配置進行無人機基地建置；待未來 EMS 派遣量能提升、得以由最近分隊出動時，再調整為最近站點導向之配置。透過資料驅動之選址最佳化與跨情境模擬，本研究結果顯示無人機具備有效縮短OHCA反應時間之潛力，進而有助於提升存活率。相關量化結果可作為未來無人機緊急救援資源實際建置與規劃之參考依據。

Out-of-hospital cardiac arrest (OHCA) survival rates decline steeply with increasing automated external defibrillator (AED) response time. Patients experiencing OHCA far from emergency medical services (EMS) stations remain structurally disadvantaged under current resource deployment strategies. This study investigates whether drone-based AED delivery can reduce response time disparities for EMS-remote OHCA cases, using optimization models under two objectives: minimizing historical EMS response time and minimizing nearest-station geographic-based EMS response time. Pareto-efficient solutions were identified and evaluated through a cross-scenario simulation framework with repeated holdout validation. Using real-world dispatch data from Taipei City and New Taipei City, Taiwan (2022–2023), results indicate that drone deployment effectively reduces response times for EMS-remote OHCA cases under real-world conditions, with stable benefits across fleet sizes. A modest number of bases is sufficient to serve a substantial proportion of cases, suggesting that base placement has a greater impact on system performance than fleet expansion. The historical-based configuration serves more cases overall, while the nearest-based configuration prioritizes patients with the longest delays, reflecting a trade-off between coverage breadth and depth of benefit. The historical-based configuration is recommended for near-term deployment, with transition to the nearest-based configuration advisable as EMS dispatch capacity improves. These findings suggest that drone-assisted AED delivery has the potential to reduce OHCA response times and improve survival outcomes, offering quantitative evidence to support future drone deployment planning.