The same reason a car has fixed and variable costs.
When you use a car, you pay for things that are proportional to the kilometers you travel (gas, tires) but you also need to compensate for costs that happen every year regardless of how much you travel (maintenance, cleaning) and even for the depreciation of the car. These fixed costs get divided by the number of kilometers that you expect to drive every year.
Same for a machine at the hospital. Someone needs to be billed for the cost of the machine. So the total cost of the machine and the other fixed costs are divided by the number of hours it is used every year.
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