The purpose of this study was to examine variations in the surgical rates among the elderly population of hospital service areas of southwest and central Virginia in order to assess whether these variations were influenced by physicians and hospitals. Procedures analyzed were specific to the elderly. Considerable variations in the rates of the selected surgical procedures were found. Some areas were found to be surgically more active than others. The variables that proved to be determinants of surgical rates were availability of general physicians and specialists and hospital occupancy rate. The impact of availability of hospital beds, per capita expenditure and ownership status of facilities were found to be mixed and inconsistent. / Master of Urban Affairs