A new report from the Irish Hospice Foundation has found that 15 counties in Ireland have no access to hospice beds.
Just two HSE regions, the Mid West and the North West, come close to fulfilling Government policy by providing one hospice bed for every 10,000 people.
The report reveals that around 2,500 patients each year are denied access to the hospice inpatient care they need because of the failure to develop hospice services countrywide.
It says there should be 450 hospice beds in the country, but today there are 155 such beds available, with another 44 beds ready but not yet operational.
The "Access to specialist palliative care services and place of death in Ireland" report says that while 67% of people express a preference to die at home, in reality only 26% of the 28,000 people who die each year manage to have that happen.
Around 43% of deaths occur in hospitals.
The report says that significant savings can be made when patients have access to comprehensive hospice inpatient and home care services, reducing admissions and lengths of stay in expensive acute hospitals.
Irish Hospice Foundation CEO Sharon Foley said: "In some areas of the country, patients at their most vulnerable are being denied access to services simply because of where they live."