地理資訊系統應用於自動體外去顫器設點研究－－以台北市萬華區為例

Choosing Optimal Locations of Automatic External Defibrillators by Using GIS Spatial Analysis-A Case Study of Taipei City Wanhua District

目標：2013年行政院衛生署訂定「公共場所必要緊急救護設備管理辦法」，於各公共場所設置必要緊急救護設備，供民眾使用急救突發性心跳停止之設備。然而，現今的自動體外去顫器（Automatic External Defibrillator, AED）配置方式還有待討論。本研究利用地理資訊系統（Geographic Information Systems, GIS）之空間分析（Spatial Analysis），想找出台北市萬華區最適合配置AED的場所。方法：本研究利用空間自相關分析檢定台北市到院前心肺停止（Out-of-hospital Cardiac Arrest, OHCA）個案之點位在空間中是否產生聚集的現象，並進行點密度分析（Point Density）以找出OHCA熱點區域，再以環域分析（Buffer Analysis）評估事故熱點的環域範圍內，其最佳設置AED場所。結果：台北市事故發生點透過全域型空間自相關檢定，Moran's Index為0.091348，且Z-score為10.161823，可得知台北市事故發生點有強烈的空間聚集現象。而區域型空間自相關結果顯示台北市萬華區為事故發生的熱區，再以台北市萬華區為例，透過點密度分析結果放大顯示熱點之中心點位，並以該點位環域範圍內，尋找最適合設置AED的醫療機構點位（醫院、診所及藥局）。結論：研究結果可提供更多的資訊以利政府迅速評估AED最佳設置處。

Objectives: In 2013, the Department of Health, Executive Yuan published the 'public places necessary emergency equipment management approach' which all public places are required to provide emergency equipment for citizens to use for sudden cardiac arrest. However, current automated external defibrillator defibrillators (AED) configurations have to be discussed. This research use the spatial analysis of Geographic Information System (GIS) to find the most appropriate configuration of the AED places in Taipei City. Methods: This research use spatial autocorrelation to determine whether Out-of Hospital Cardiac Arrest (OHCA) is uniformly distributed, and detect OHCA hotspot by using point density analysis. Lastly, we conduct multiple ring buffer to identify locations of OHCA hot spots and decide the locations to set AEDs. Results: Based on the above method, Moran's Index is used in this research to measure the spatial association of OHCA. The result (Z-score = 10.161, P ＜ 0.001) have shown that the distribution of OHCA exhibits a spatial autocorrelation. The research use Point Density to identify OHCA hot spots. The result indicate that Wanhua district, Datong district and Zhongshan district are the most densely distributed OHCA area. In our example, through the method of multiple ring buffer, we found Wanhua district need to place AED around 100- 200m on the OHCA hot spots. (hospitals, clinics, pharmacis or convenient stores). Conclusions: This method can provide valuable information for government to assess the resources allocation and find the best setting of AED.