What were the main factors responsible for the growth of hospitals until the latter part of the 20th century?

What were the main factors responsible for the growth of hospitals until the latter part of the 20th century?

Name the main forces that have been responsible for hospital downsizing? How has each of these downsizing forces been responsible for the decline in inpatient hospital utilization?

Two responses: one 300-500 word contributions per session in the body of the DB. No file attachments. First response should address the posted discussion question(s), Responses should be thoughtful and reflect a comprehension of the assigned readings. APA format for in-text citations and references.
The book
Delivering health care in American
Leiyu Shi , Douglas A. Singh 6th edition