Background: Hospitalizations for asthma and COPD exacerbations frequently occur in Thailand. National trends in hospital outcomes are essential for planning preventive strategies within healthcare system.

Objective: To examine temporal trends in in-hospital outcomes, including mortality rate, length of stay (LOS), and expenses for reimbursement, in adults hospitalized for asthma and COPD in Thailand.

Methods: This study utilized a dataset from the National Health Security Office in southern Thailand to conduct a population-based retrospective study in adults hospitalized for asthma and COPD exacerbations. We assessed baseline demographic and in-hospital outcomes in 19,459 and 66,457 hospitalizations for asthma and COPD from 2017-2021, respectively. 

Results:  The total number of hospital admissions for asthma and COPD exacerbations significantly decreased over time, especially in 2020/2021. From 2017 to 2021, the in-hospital mortality rate for asthma increased by 3.2 to 3.7 deaths per 1,000 admissions (P<0.05). Those rates in COPD decreased from 2017 to 2020 (20.3 to 16.4 deaths per 1,000 admissions) but abruptly rose to 21.8 in 2021 (P<0.05). Increasing age mainly contributed to a higher mortality rate. The average LOS slightly reduced over the study period in either asthma or COPD admission. The overall expenses for reimbursement in  per hospitalization significantly increased yearly, particularly in 2020/2021. 

Conclusion: During 2017-2021, exacerbations of asthma and COPD in Thailand continued to account for significant in-hospital mortality rates and expenses for reimbursement despite the reduction in overall hospitalizations.