Greater availability of primary care has also been shown to increase satisfaction with the health care system and decrease utilization of hospital care and emergency department visits (3).
Additionally, research shows that if patients are more engaged and play a more active role in their health care is associated with greater satisfaction with care, increased adherence, more knowledge, improved health status and a decreased utilization of health care services [ 7].
The two major mechanisms for high ketone concentrations in patients with diabetes are increased production from triglycerides and decreased utilization in the liver both of which are due to an absolute or relative insulin deficiency and increased counter-regulatory hormones, including cortisol, epinephrine, glucagon, and growth hormone (183).
Relatives also voiced concern that a lower-risk test result might give a false sense of security and lead to decreased utilization of PCa screening.
Few studies have evaluated the relationship between Native American ethnicity and PTB, with one study showing that this group has increased maternal risk factors (e.g., tobacco and alcohol use, hypertension), decreased utilization of prenatal care and a 32.5% higher PTB rate as compared to non-Hispanic whites [ 13].
Additionally, decreased phosphorylase kinase would favor decreased conformational change of phosphorylase b to phosphorylase a, and reduced glycogen breakdown to glucose 6-phosphate and decreased galactokinase would favor decreased utilization of galactose for glycolysis.
The most important, and unexpected, regional difference involves the decreased utilization of DOs among females in the West.
However, the experience of user fees for health care in the region showed adverse effects in the form of, among other things, decreased utilization of services and impoverishment of households as a result of payment for health care.
However, it was also noted that decentralization resulted in poor quality of maternal health services, decreased coverage of immunization programmes, and weak supervision which led to decreased utilization of services [ 24, 25].
