Assessing the inequality of lifetime healthcare expenditures: A nearest neighbour resampling approach

The rise in healthcare expenditures has raised doubts about the sustainability of health systems and instigated a discussion on their design. Policy making in this field requires a proper understanding of how healthcare expenditures evolve throughout an individual's lifetime, and of how they vary between individuals. Given the lack of data on healthcare expenditures during an individual's lifetime, we developed a new nearest neighbour resampling approach to construct realistic individual life cycles of healthcare expenditures based on cross-sectional data from the Netherlands. This approach provides insight into lifetime healthcare expenditures. Our main finding is that the inequality in lifetime healthcare expenditures is much smaller than the inequality as derived from cross-sectional healthcare expenditures.