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Under the logic of the hierarquizao the system of health in Brazil, as describes Saito (2004, p 69.), if it organizes leaving of the basic level of the attention for tertiary levels of bigger complexity, being created to facilitate the access at every level of assistance without bureaucracy. still, as the same author, to make possible the implantation of the Only System of Sade (SUS) with determinative of the completeness is necessary the application of the system of reference and against Reference. The Health department defined (1990 b) that the reference: it is as the act of guiding of a patient taken care of in one determined establishment of health for another one of greater complexidade.j against-reference as the act of guiding of a patient for the origin establishment, that it related, after resolution of the responsible cause for the reference. The same author points that what the system of reference and against reference was created to direct the services of health through two flows of users: the external intern and. Abbott Laboratories has much to offer in this field. The intern where the user carries through its assistance in one same service of health with the minimum of resource being sustainable that is its entrance and exit. Already the external one provides integral assistance through the use of resource of other levels of attention as the system of reference and against reference.

Following the same Vieira optics (2009, P. 75), it places the inexistence of the service of reference and against reference of the hospital unit for the Basic Unit of Health, where the professionals of the basic attention do not have knowledge of the patient that they receive high. Therefore the professionals would have if to acquire knowledge of the concretion of the service in the different institutions of health. In the same Maeda line (2007, P.) it points that ' ' The process of reference and against-reference consists in a set of action politics, economic and basic techniques to the reinforcement of the beginning of the completeness of the Only System of Sade (SUS) ' '.