The Medellin General Hospital it's a decentralized entity of public nature from the Medellin city. It counts with an autonomous budget for it's operation, besides that the Medellin General Hospital health attention has a third level of complexity. Nowadays like any other IPS of public character the Medellin General Hospital confronted to the management portfolio problems because the tight and meager payments of the insurers to whom its provides its services (a collection average of 210 days), with a high operation costs where the labor represents 52% of the total costs and due to recent governmental regulations tending to dignify the laboral activity, has taken to the personal entailment that provides its services therein, turning in fix cost what it was variable before. Thence the importance of the present work that looks through the quantitative analysis developed by the analysis of scenarios evaluate the impact of fix and variable costs on sales and hence the utilities, trying to identify the optimum mixing that allows maximize the use of resources and at the same time the utility, allowing to this entity is't survival, sustainability and just like that to keep up with the service to a vulnerable and poor population, which constitute nowadays it's objective market and it's what we're all about.