CINCINNATI — Although it is nearly 2,000 miles from Boise, Idaho, Cincinnati Children’s Hospital means to make a visit here worth a patient’s journey.

Not content to play a regional role, the Cincinnati Children’s Hospital Medical Center has emerged as a national name in pediatric medicine, drawing patients from distant cities like Boise.

Over the last year, 26 percent of its 14,300 pediatric patients have come from outside the Cincinnati area, compared with 19 percent five years ago.

Reasons for the hospital’s national renown include its market-niche focus on certain rare or complex conditions. A medical-team approach coordinates the efforts of the various specialists who handle each child’s case.

There is also diligent attention to quality and efficiency, inspired by a chief executive from a manufacturing background.

And then there is a distinction that might seem unremarkable if it were not so infrequent in American health care: Cincinnati Children’s Hospital rigorously tracks how its patients fare, both in the hospital and after they leave.

Many hospitals might claim to offer high-quality care. But they often have only the vaguest notion of how well their patients are doing, aside from a few basic measures like whether they survive surgery.

Cincinnati Children’s is among the relatively few medical centers that meticulously collect a wide range of data, to let the hospital see whether patients are getting good, effective care — and to look for ways to improve.

By precisely tracking how many patients develop surgical infections, for example, and why, Cincinnati Children’s has been able to identify ways to reduce that number by more than half — to 42 last year compared with 95 in 2005.

By carefully charting measures like the range of joint motion achieved by juvenile arthritis patients, to cite another example, the hospital is trying to identify the most effective therapies and adopt them as standard treatments.

And demonstrating the value of dealing with the practical aspects of a patient’s medical condition, Cincinnati Children’s can point to data showing that 95 percent of children with severe intestinal abnormalities who complete its bowel-management program are able to leave wearing normal underwear.

One recent beneficiary is Matthew Swan, an 8-year-old from just outside Boise with a rare congenital disorder affecting his large intestine. After treatment at Cincinnati Children’s, Matthew for the first time in his life is able to attend school full time.

Identifying specialties where it can excel, and pursuing them with a business-minded operational rigor, helped the nonprofit hospital take its place among the nation’s best pediatric centers. It now vies for patients with the likes of Children’s Hospital Boston, affiliated with Harvard, or the Children’s Hospital of Philadelphia.

Lacking the prestige of other well-known pediatric centers, Cincinnati Children’s had to learn to compete on something else, said Dr. Charles Homer, the chief executive of the nonprofit National Initiative for Children’s Healthcare Quality. “The something else is quality.”

The hospital’s national emergence has been led by James M. Anderson, a former corporate lawyer who ran an industrial valve maker before becoming the hospital’s chief executive in 1996. The goal, he said, is to make “the experience you have in Cincinnati Children’s to be so much better an experience you want to come here.”

The strategy’s success can be measured in the hospital’s operating revenue, which has grown by about 50 percent over the last three years, to just over $1 billion for fiscal 2006. The figure includes the mounting research grants pulled in by some of the top medical specialists whom Mr. Anderson has recruited from around the country.

“Cincinnati Children’s is a good example of a provider moving voluntarily down the path towards value-based care delivery or value-based competition,” said Michael E. Porter, a Harvard Business School professor.

He is an author of the book “Redefining Health Care,” which argues that hospitals should compete on the basis of their proven success in treating particular medical conditions.

The competitive strategy at Cincinnati Children’s evolved about six years ago from a period of soul-searching as Mr. Anderson sought a strategic mission for the hospital.

Although it had always enjoyed a strong reputation, there was a growing consensus among doctors and other employees that the hospital was falling short of its own expectations, said Lee A. Carter, a retired marketing executive who is chairman of the hospital’s board.

“It really woke us up,” he said, recalling a collective realization that “we’re not as good as we thought we were.”

One area with significant room for improvement was treatment of cystic fibrosis patients. Data from the Cystic Fibrosis Foundation showed that patients at Cincinnati Children’s were not doing nearly as well as those at other leading treatment centers around the country.

Mr. Anderson’s team decided to confront those shortcomings. Cincinnati Children’s took the potentially risky step of sharing the unflattering data with the parents of cystic fibrosis patients, as it embarked on a project to improve the results of the hospital’s care.

Among other steps, the hospital began tracking the lung function of the patients more closely, ensured that more of them got flu shots and concentrated on improving the nutrition of those who were seriously underweight.

Although Cincinnati Children’s is still not among the top-performing hospitals in treating cystic fibrosis, it has made significant strides, according to national data that now puts it solidly above average in measures like lung function or nutritional status.

Mr. Anderson used his manufacturing background to help the doctors break problems down into distinct steps for improving the hospital’s care. Until then, even when they knew care could be better, the doctors “didn’t know it was fixable,” recalled Dr. Uma R. Kotagal, the physician in charge of quality improvement at the hospital.

As the only pediatric hospital in the area, Cincinnati Children’s continues to provide its share of basic care to local children. But it also aims to reduce the number of patients who should not be there in the first place.

A few years ago, Cincinnati Children’s started a successful program with local pediatricians to better manage asthma in the community by making sure every patient had a treatment plan and that doctors had a way of responding to problems that surfaced when their offices were closed.

There has been a significant drop in the number of asthmatic children showing up in the hospital’s emergency room or being admitted.

The nation’s other top-tier children’s hospitals are taking similar approaches, trying to concentrate on the sickest children, for whom reimbursements are typically the most generous, said Mark Wietecha, the chairman of Kurt Salmon Associates, an Atlanta consulting firm that works closely with academic medical centers and children’s hospitals.

“Dehydrated kids are not a future,” he said.

These days, Cincinnati Children’s devotes its energy to narrow specialties where it can develop a true expertise — like Fanconi anemia, a rare genetic disease that leads to bone marrow failure.

The hospital says it now treats about one-third of the nation’s 300 or so children with the condition. That relatively high volume of cases lets doctors acquire the experience critical to good care, while also enabling Cincinnati Children’s to gain further expertise by conducting extensive research into the disease.

The more patients it attracts in one of its specialties, in other words, the better care the hospital can deliver, making it even better able to compete for future patients.

Two years ago Mr. Anderson recruited a pair of well-regarded specialists to start the hospital’s center for diseases of the colon and rectum.

The colorectal center enables children to get coordinated treatment from different specialists, and spares parents the frustration of navigating a maze of tests, consultations and procedures by handing them a detailed itinerary when they arrive.

Hospital officials say the center, which treated 430 patients last year, is the only one of its kind in the country.

“Nobody has seen the number of patients we have seen,” said Dr. Alberto Peña, the center’s director, who had been chief of pediatric surgery at Schneider Children’s Hospital, part of the North Shore Long Island Jewish Health System in New York.

He was recruited along with Dr. Marc A. Levitt, also from North Shore, who is the center’s associate director.

One of those patients has been Matthew Swan, a third-grader, who has a serious congenital condition called Hirschsprung’s disease that affects his large intestine’s ability to process food.

Unable to find specialists closer to their Idaho home, his mother had been taking him to a children’s hospital in Michigan.

But Matthew was still a frequent visitor to emergency rooms because of chronic intestinal infections and was unable to attend a full day of school.

“We were told that this was just the way it has to be,” said his mother, Jaqueline Swan. Unwilling to accept that conclusion, Mrs. Swan researched colorectal programs, spoke to other parents and chose to come to Cincinnati Children’s.

Recognizing that Matthew has an especially rare form of the disease, the Cincinnati doctors took him off the high-fiber diet that is usually suggested and stopped the use of laxatives. And Matthew received the help he needed, including recent surgery, to better control his bowel movements.

While some hospitals might simply stop at the surgery, Cincinnati Children’s sees part of its job as helping each patient learn to live as normal a life as possible. In the case of patients like Matthew, that means ensuring that the vast majority end up able to remain continent, Dr. Levitt said.