The UK spends £11.7bn on people’s health in the last year of their life, largely on hospital care even though most would rather die at home or in a hospice.

The stark disparity is “robbing many tens of thousands of dying people of the chance to remain where they want to be in the final chapter of their life”, according to Marie Curie. A report from the charity has revealed that, in all, Britain spends £22bn a year on health care, social care and welfare benefits for people who will be dead within 12 months.

Of the £11.7bn spent on health needs, £9.6bn (81%) goes to hospitals and out of that, more than two-thirds, £6.6bn, is used to provide emergency care such as in A&E.

The findings come as MPs consider how to introduce assisted dying for people with a terminal condition who have less than six months to live. The Labour MP Kim Leadbeater’s private member’s bill has prompted widespread agreement that end of life care needs a dramatic expansion.

Marie Curie and other groups that provide end of life care want ministers to divert some of the £9.6bn hospitals receive into a massive increase in letting people choose to die in other settings. During 2022, 656,400 people died across the UK, according to its report, which was put together by the Nuffield Trust thinktank and the NHS’s health economics unit. Of those, 289,121 (44%) died in hospital – more than in any other setting – even though evidence shows that most people want to end their life somewhere else.

“Through inadequate community care for people in the final year of life, we are currently robbing many tens of thousands of dying people of the chance to remain where they want to be in the final chapter of their life. It is inexcusable and it cannot be ignored any longer,” said Dr Sam Royston, Marie Curie’s executive director of research and policy.

“No one wants to be calling an ambulance in the middle of the night because they can’t get the support they need at home, or facing long stays in hospital when they don’t want or need to be there, but that is the shocking reality for far too many dying people.”

Keir Starmer has said that hospices play a “vital role” in helping people have the best possible end to their life and the government recently gave the hospice sector an extra £100m for its work.

Wes Streeting, the health secretary, has described the fact that hospices get only a third of their funding from the government, and the other two-thirds from donations, as unfair.

“This report shows that the way we look at care at the end of someone’s life is not working, for dying people, their families or the public purse”, said Katie Reade, the head of policy and public affairs at Hospice UK.

That so many people die in hospital despite wanting to do so elsewhere is “distressing for patients and families [and] is also an inefficient use of public money, which could be better spent on giving people comfort and dignity”.

James Sanderson, the chief executive of Sue Ryder, a hospice and palliative care provider, urged ministers to set up a network of hospices in hospital grounds so that patients approaching the end of their life can be looked after there, which would also free up beds in overstretched hospitals.

The Department of Health and Social Care did not comment directly on the Marie Curie findings. A department spokesperson said: “Hospices carry out incredible work to ensure patients get the care they need in the most appropriate setting.

“That’s why we recently announced the largest investment in hospices in a generation. This £100m funding boost will improve facilities and allow them to focus wider resources on patient care. We are working to make sure the sector is sustainable overall in the long term.”