Tens of thousands of Australians are dying in places that do not reflect their choices or meet their needs, a scathing Productivity Commission report has found.
The broad-ranging human services report published on Monday also found Australia's social housing system was broken, and supports offered to those experiencing hardship were ineffective.
"A stronger focus on users, better service planning and improved coordination across services and levels of government is needed," the report said.
The commission has recommended a raft of changes to significantly expand community-based palliative care and improve end-of-life services in residential aged care.
"State and territory governments should increase the availability of community-based palliative care so that people with a preference to die at home can access support to do so," its report said.
"End-of-life care should be core business for aged care facilities, and the quality of end-of life care in residential aged care should align with the quality of that available to other Australians."
The commission argued community-based palliative care ought be designed around service gaps, and standards established for those who wish to and are able to die at home.
It also suggested the integration of nursing, medical and personal care along with a competitive approach to selecting, monitoring and evaluating service providers.
In residential aged care facilities, the commission urged the removal of restrictions on the duration and availability of palliative care funding.
Doctors should be encouraged to canvass the topic with older patients, and residential aged care facilities required to ensure clinically trained staff talk to residents about their future care needs, the commission said.
It urged state, territory and federal governments to work together on planning, funding and delivering end-of-life care and collect data on patients.
On social housing, the commission recommended establishing a single system of financial assistance and tenancy support services across private and public rental properties.
It argued for a sharpened focus on improving outcomes in family and community services, and a more responsive and place-based approach to delivering services in remote indigenous communities.
Having also investigated health care, the commission argued patients ought be given more choice in selecting specialists and public dental providers.
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