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Compared to other OECD countries, Switzerland has the highest rates of hip (HA) and knee arthroplasty (KA). We assessed the regional variation in HA/KA rates and potential determinants of variation in Switzerland. We conducted a population-based analysis using discharge data from all Swiss hospitals during 2013-2016. We derived hospital service areas (HSAs) by analyzing patient flows. We calculated age-/****-standardized procedure rates and measures of variation (the extremal quotient [EQ, highest divided by lowest rate