End-of-life care utilization in Korea remains strongly hospital-centered, and the cost-effectiveness of hospice & palliative care varies by service delivery model, with particularly notable cost savings in home-based services. In this context, if a quality-oriented approach to end-of-life care is insufficient, unnecessary hospitalizations and aggressive treatments may persist, leading to increased inefficiency in healthcare utilization and a structural rise in financial burden. This study provides both quantitative and qualitative evidence to support policy directions for integrating hospice and palliative care into a quality-focused end-of-life care system in Korea.