The burden of schizophrenia is large and multifaceted. Economic costs are one of the most important components. This study provided an overall estimate of the costs of schizophrenia, but it can not capture all costs, as noted by other researchers, two types of the costs were always underestimated: the cost to families and the costs of publicly owned capital.
In the present study, the sample were selected from two areas, one of which was from northern China and another was from southern China, the two centers were not selected randomly, hence, the results of the study reflected only the cost of schizophrenia in two areas of China. Centers taking part in were located in the north and south of China, but none in the west and east of the country. The sample seems not to be representative of the cost of schizophrenic patients in China (mainland). The sample was not quite large, only patients, not centre, were randomly selected, and only two centers were selected. We have not found suicide cases, however, the cost due to suicide are the important parts.
We study the economic cost of schizophrenia with human capital approach(HCP), however, HCP has many limitations, it has many assumptions that are not likely to hold, e.g. it assumes that there is full employment. Goeree  valuated the productivity costs due to premature mortality and compared the human capital approach and friction cost (FC) methods for schizophrenia.This study showed that productivity-cost estimates from the human capital approach are substantially higher than those obtained from the FC method. In circumstances of unemployment, the human capital approach is an overestimate of future productivity losses for premature mortality. All the limitations mentioned-above must be borne in mind.
Despite these limitation, the results from the present study show that schizophrenia cause a substantial economic burden to healthcare systems, community, other caregivers and society. The per case per annum total cost, direct cost and indirect cost amounted to US$2586.21, US$862.81 (33.4%) and US$1723.40 (66.6%) respectively. Indirect costs were the great majority of the economic cost of schizophrenia. In the indirect cost, cost due to lost working days and disability were the great majority. Schizophrenia is correlated to loss of working days, lack of well-being and poor levels of social functioning. Theses are the main results drawn from the analysis of indirect costs that appear to be exclusively borne by patients, caregivers and ultimately society as a whole. These findings are consistent with the majority of results of other cost of illness studies on schizophrenia where indirect costs vary from 48% to 86.5% of total cost [21–24]. Hence we must pay close attention to the indirect of the cost of schizophrenia, take effective measure to improve the social function and reduce the time cost and other indirect cost.
China is a large developing country, the per case pure income of rural residents was about US$450, about 60% patients of our sample were peasants, students or unemployed, the total cost, amounted to US$2586.21, was heavy for them and their families who had been very poor because of the chronic illness.
A study carried out by Andlin-Sobock  shown that the cost per case of schizophrenia differs significantly across the different country in Europe, range from €2360 (Estonia) to €13862 (Switzerland). In every country, the cost per case of schizophrenia was higher than other mental illness. Their findings shown that the cost per case of schizophrenia differs between countries and are highest in countries with the highest national income and healthcare expenditure. This explains the estimated lower cost per case in China. In comparison with European countries, condition with relatively low cost, in schizophrenia, was associated with the lower level of economy development.
The total cost, direct cost and direct medical cost of per case of in-patients was higher than out-patients of schizophrenia. The reason, might be stated that the medical model in China was different from other countries. There are various medical model for the management of schizophrenia such as day-care center, day-hospital, patients’home, community mental health centers (CMHCs), sheltered workshops, psychiatric ambulatories and national health service as well in developed countries . However it is not the same case in China, patients have to stay at home to take medicine except for hospitalization in mental hospital and seeing doctor in out-patient, have no other choice. During hospitalization in mental hospital patients could receive various kinds of treatments, hence the direct medical cost, direct cost, total cost will increase. During non-hospitalization patients receive no treatment except for drug therapy, hence all kinds of cost will decrease.
There was significant difference in per case per annum total cost, direct cost, direct medical cost, cost due to lost working-days and disability of patients between urban and rural schizophrenic patients, the former is higher than the latter. In China, expensive new antipsychotics were mainly applied to urban patients but few to rural patients, drug cost was the main part of direct medical cost to a turn, lead to the increase of direct cost and total cost. Cost due to lost working days and disability of urban patients are higher than rural patients because the economic income of urban residents was higher than rural residents in China.
Multivariate regression analysis shows that cadre professional, paranoid type schizophrenia, urban patients, in-patients and southern researcher centre were correlated with higher total costs.
The reason why the cost of urban patients and in-patients were higher is in line with the explanation above. Cadres (civil servants) are a special population with higher economic level in China. In general, their income was higher than peasants and people being unemployed, they would pay more money to the treatment of schizophrenia. It is differs from the finding of Percudani in Italy [11, 25], they found being unemployed was associated with higher service cost. Percudani also found that the total cost per patients differ wildly according to whether patients had been hospital during the observation period. Patients with a previous psychiatric contact and a longer duration of illness were more costly than the other patients [11, 25].
Similar with cadres (civil servants), most urban schizophrenic patients had regular income, good family economic condition, more medical knowledge and saw doctros in the early stage of the illness. They usually took new and expensive medicine. Conversely, most rural patients were peasants or people being unemployed, they had lower economic income and poor family economic condition, they could not afford to enormous economic pressure. These patients could not be hospitalized in time and they usually took cheaper medicine, so their costs were lower. Residual type schizophrenic patients had longer duration of illness and poor prognosis, with more difficulties in treatment and rehabilitation and higher probability of hospitalization, so their costs were higher.The reason why southern researcher centre correlated with higher costs was complex. The main reason was associated with economic development.
Economic cost was a complex index which was affected by many factors, not just related with the medical factors. In addition to the five factors getting into the regression equation, there were a lot of other factors influencing the economic cost of the schizophrenic patients. So the five factors can only explain the dependent variable (total economic costs) 27.41%, other factors and accidental factors accounted for 72.59%.