TORONTO -- A group of doctors says Canada's approach to palliative care must be broadened to provide end-of-life support to patients with serious chronic illnesses, not just those with cancer.

Their analysis in the Canadian Medical Association Journal suggests much needs to be done to improve access to palliative care, especially for patients with such conditions as heart failure and chronic obstructive pulmonary disease, or COPD.

The authors say Canada is ranked 18th worldwide by the Economist Intelligence Unit for provision of palliative care, and it lags behind Mongolia and Panama in strategies to develop and promote such services to patients.

Co-author Dr. Graeme Rocker of Dalhousie University says two-thirds of the 250,000 Canadians who die each year have illnesses other than cancer, yet most don't have access to the same types of support as cancer patients.

The authors suggest all physicians need to be educated about providing palliative care to their patients, and that services should be home- or community-based rather than delivered primarily in hospitals.

Rocker says most Canadians prefer to die at home or in a hospice, but too often a lack of community-based services means they end their lives in a hospital bed.