National trends in emergency department closures, mergers, and utilization, 2005-2015.

PLoS One · 2021 · PMC8136839 · PMID 34015007

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an increasing trendno p-value reported

First many states have expanded Medicaid and secondly an increasing trend in hospital closures.

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an overall trendno p-value reported

This is part of an overall trend in American healthcare towards organizational consolidation, with potential implications for one of the key aspects of access to care: geographic availability.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.