<p>Online Resource 1.</p><p>Testing the Markovian assumption: hazard ratios for the effect of sojourn duration (time spent in a given state) on subsequent transitions</p><p>Lombardy England Association HR 95% CI HR 95% CI Inpatient LOS and: Community to hospital 1.001 1.001-1.002 0.993 0.992-0.994 Community to death 1.008 1.007-1.008 1.008 1.008-1.009 Time in community and: Inpatient to live 1.000 1.000-1.000 1.000 1.000-1.000 discharge Inpatient to death 1.000 0.999-1.000 1.000 1.000-1.000 Hazard ratios (HRs) are given to 3 decimal places Online Resource 2. </p><p>Probability (as %) that each state will be the next one given that the patient changes state, 3-state model without covariates</p><p>Region Live discharge Death in Readmission Death out of hospital hospital Lombardy 91 9 66 34 All England 84 16 44 56 Q30 North East Strategic 85 15 44 56 Health Authority Q31 North West Strategic 82 18 44 56 Health Authority Q32 Yorkshire and The 83 17 43 57 Humber Strategic Health Authority Q33 East Midlands 84 16 44 56 Strategic Health Authority Q34 West Midlands 84 16 46 54 Strategic Health Authority Q35 East Of England 82 18 42 58 Strategic Health Authority Q36 London Strategic 87 13 50 50 Health Authority Q37 South East Coast 84 16 41 59 Strategic Health Authority Q38 South Central 83 17 40 60 Strategic Health Authority Q39 South West Strategic 82 18 39 61 Health Authority</p>