Primary Children's lost ground in all but one specialty; its neurology care moved up from 33rd to 16th place. And unlike last year, it didn't place in cancer or nephrology.
Small slips and gains in scores can reflect swings in patient loads or staffing changes, said the hospital's CEO, Katy Welkie, who uses the report to help guide care improvement plans.
The report favors better-known hospitals in large cities. A quarter of a hospital's score rests on a survey of physicians who are asked to name up to 10 centers they consider best for children, without regard to price or location.
But reputation used to play an even bigger role, said Welkie, noting the report today places more emphasis on clinical data.
Hospitals were judged on staffing levels, patient care and patient safety and asked to supply data, for example, on complications from kidney infections or three-year cancer survival rates. The report also weighed efficiency and coordination of care.
"What's impressive for Primary is even though we rank low for reputation, we rank high in the quantitative elements around nursing staffing and survivability," Welkie said.
She said she would like the rankings to also consider "value of care," since "what we charge a patient is much lower than what other children's hospitals around the country charge."
Children's Hospital of Philadelphia wrested the No. 1 spot from the Boston Children's Hospital by claiming a top-three rating in 9 categories.
See the complete 'Best Children's Hospitals' report online.
Utah counties: How healthy for kids?
Utah is often ranked among the nation's healthiest states, but none of its counties is included in a U.S. News & World Report ranking of the 50 healthiest counties for kids.
About 1,200 of the nation's 3,143 counties were evaluated for the rankings, including a handful from Utah, said the report's author, Steven Sternberg. Some of Utah's counties placed in the top 100, he said, but none made the cut for the report.
Three Colorado counties were ranked, including Boulder County at No. 7.
Sternberg, however, cautioned against drawing easy conclusions. "I'm not sure we've learned all we can from the data yet. It's a much more complicated picture than we realized," he said.
One well-known indicator of poor health, for example, is poverty. But New York County, which placed No. 38, has a child poverty rate of 27 percent well above Cache County, which has a rate of 17 percent and was named Utah's second healthiest county by the state health department.
Data used for the report span several years and came from an array of mostly federal sources, making it hard to identify where Utah may have fallen short, said state Department of Health epidemiologist Laurie Baksh.
But at first glance, she said, it appears Utah would do well to improve its uninsured and child poverty rates, and boost its per capita number of primary care doctors.