OBJECTIVES: Despite nearly 25 years of experience with recombinant human growth hormone (GH) treatment modalities vary significantly between centres and regions and final outcome of GH therapy varies widely . In a country like Germany, for example, children with growth disorders are treated with Genotropin® (Pfizer Inc, New York) in more than 150 institutions with different levels of experience. METHODS: Data collected from more than 75,000 children with growth disorders treated with Genotropin are followed-up worldwide in a large, pharmaco-epidemiological database (KIGS, Pfizer International Growth Study). Country specific datasets are used to compare treatment standards and demonstrate differences between individual centres and the country as a whole. Site-specific, individualized reports enable clinicians to anonymously benchmark the quality of care in their treatment centre. Quality indicators (like diagnostic tests, height and height velocity, GH dose, treatment response and responsiveness, treatment duration, adverse events, completeness of documentation) are followed and compared. RESULTS: Structural aspects as well as process and outcome indicators differed between the paediatric endocrinology centres, e.g. age at start of therapy, GH doses and diagnostic procedures. The reports allowed self-audit of clinical practice, sharing of best practice and promote discussion of clinical decision making in paediatric specialist care forums. CONCLUSIONS: The KIGS Quality Insight (KIGS QI) program provides a successful approach to unmask deficits and to improve the outcome of care. The output from the centre and country specific analysis allows identification and follow-up of GH non-responders and assists with demonstration of standard of care and treatment outcomes in the country to hospital managers, guidelines committees and payers. Results from KIGS can be successfully used to enable investigators to compare their treatment centre with the country as a whole and to assess changes over time.