A survey of primary care physicians in 11 countries has found that the United States lags on important measures of health care access, quality and use of information technology.

“A Survey of Primary Care Physicians in 11 countries, 2009” was released Thursday by the Commonwealth Fund, a private foundation based in New York that aims to promote a high-performing health care system that improves access, quality and efficiency.

The research found that 58% of U.S. doctors—the most of any country surveyed—said their patients often have trouble paying for medications, care or other out-of-pocket costs. By comparison, the highest of any other country in the survey was 37%.

On another subject, the survey found that only 29% of U.S. physicians said their practice had made arrangements to provide after-hours care, while nearly all doctors in the Netherlands, New Zealand and United Kingdom said after-hours care arrangements had been made to avoid emergency room visits.

Only 46% of U.S. doctors use electronic medical records, compared with more than 90% of doctors in Australia, Italy, the Netherlands, New Zealand, Norway, Sweden and the United Kingdom.

Further, the survey found that U.S. primary care physicians are among the least likely to be offered financial incentives to improve the quality of care, with only one-third of the 1,442 U.S. doctors surveyed receiving financial incentives.

The survey concluded that despite spending more money on health care than other countries, the United States is behind in most areas and “there are opportunities to learn as other countries move ahead to enhance the primary care foundations of their health care systems.”

The Commonwealth Fund surveyed more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom and the United States.

Survey topics included health care system views and satisfaction, access to care, managing chronic illness, information technology, measuring practice performance, and financial incentives.

The survey is available online at www.commonwealthfund.org.