Objective: This study aimed to identify the clinical characteristics associated with the failure to achieve clinical remission in asthma. Methods: A retrospective 3-year cohort study was conducted in an outpatient chest department, with data recorded from National Health Insurance claims and the “Pay for Performance Program for Asthma” (P4P). Results: A total of 285 patients were screened between January 2021 and December 2023, of whom 143 were included in the analysis. The cohort had a mean age of 57.6 years; 62.2% were female, 14.0% were current smokers, and 17.5% had a baseline ACT score below 20. Clinical remission was defined as an ACT score≥24, FEV1≥80% of the predicted value, and no exacerbations for at least six months. After a minimum of six months of follow-up, 56.6% of patients failed to achieve remission. Non-remission was significantly associated with smoking (adjusted odds ratio [aOR] 4.944, p=0.023), ACT scores<24 (aOR 4.669, p=0.003), FEV1 < 80% (aOR 17.892, p<0.001), and recent exacerbations within three months before enrollment (aOR 3.441, p=0.033). Baseline differences in age, BMI, sex, comorbidities, and blood eosinophil counts were not statistically significant. Conclusion: These findings identified risk factors for non-clinical remission and provide practical insights for asthma management in community hospitals.