As populations age and chronic conditions rise, the demand for end-of-life care is becoming a critical issue across OECD countries. Although most people would prefer to die at home, the majority still die in hospitals, partly due to limited access to home-based services. This policy brief explores the gap between people’s preferences for end-of-life care and the care they actually receive, examining factors such as funding allocation, palliative care availability, and the role of family caregivers. It outlines policies that can improve access to home-based care, ensuring that individuals can die in their preferred setting while receiving high-quality, affordable, and people-centred care.