The aim of the research was to develop and implement a " Plan of reference and against reference" that will contribute to improve the offer of health services in the outpatient through the organization and the proper functioning of the system which is based on criteria of opportunity, accessibility and hospital response capacity to meet the health needs of especially the most vulnerable population. The method used was descriptive, explanatory and scientific. The technique used was the survey applied to patients. The most important results were "Diagnosis of the reference and against reference of the department of La Libertad and its incidence in the province of Trujillo in 2012" and "Analysis of the supply of health services in outpatient of the seven hospitals II-1 in the province of Trujillo in 2013” which concluded that the problem was the deficit in supply at the external consultat...